PD13-10 DIABETES AND PROSTATE CANCER OUTCOMES IN MEN WITH NONMETASTATIC CASTRATE-RESISTANT PROSTATE CANCER: RESULTS FROM THE SEARCH COHORT

You have accessJournal of UrologyCME1 May 2022PD13-10 DIABETES AND PROSTATE CANCER OUTCOMES IN MEN WITH NONMETASTATIC CASTRATE-RESISTANT PROSTATE CANCER: RESULTS FROM THE SEARCH COHORT Andrei Sergeyev, Lin Gu, Amanda De Hoedt, Christopher Amling, William Aronson, Matthew Cooperberg, Christopher Kane, Zachary Klaassen, Martha Terris, Lourdes Rivera, San Juan, Puerto Rico, Stephen Freedland, and Ilona Csizmadi Andrei SergeyevAndrei Sergeyev More articles by this author , Lin GuLin Gu More articles by this author , Amanda De HoedtAmanda De Hoedt More articles by this author , Christopher AmlingChristopher Amling More articles by this author , William AronsonWilliam Aronson More articles by this author , Matthew CooperbergMatthew Cooperberg More articles by this author , Christopher KaneChristopher Kane More articles by this author , Zachary KlaassenZachary Klaassen More articles by this author , Martha TerrisMartha Terris More articles by this author , Lourdes RiveraLourdes Rivera More articles by this author , San JuanSan Juan More articles by this author , Puerto RicoPuerto Rico More articles by this author , Stephen FreedlandStephen Freedland More articles by this author , and Ilona CsizmadiIlona Csizmadi More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002545.10AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Men with non-metastatic castration-resistant prostate cancer (nmCRPC) have a poor prognosis with a third of patients developing metastases or dying within a median of 2.5 years. Given the substantial overlap between diabetes and PC in elderly men, a large body of research has investigated the relation between diabetes and PC risk; however, the association between diabetes and PC progression, particularly among men with more advanced disease, has been under-studied. To address this gap, we studied the association between diabetes and the development of metastases, PC-specific mortality (PCSM) and all-cause mortality (ACM) in men with nmCRPC. We also tested if associations were modified by race. METHODS: Men with nmCRPC between 2000-2017 at 8 Veterans Affairs hospitals in the SEARCH Cohort were included. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox proportional hazard models to test associations between diabetes and outcomes adjusted for age, race, body mass index, hospital site, biopsy grade, log-transformed PSA, and primary localized treatment. Competing risk analyses were carried out for PCSM. Interactions between diabetes and race (Black vs White) were assessed for all outcomes and evaluated for statistical significance. RESULTS: Of 984 men (median age: 76 years), 153 (15%) had a history of diabetes, 667 (68%) of men were White, 284 (29%) were Black and 33 (3%) were classified as ‘Other’ At baseline, median prostate specific antigen levels were 4.50 ng/mL. During a median follow-up of 6.5 years, 567 men were diagnosed with metastases, and 485 PCSM and 745 ACM events occurred. In multivariable-adjusted models, diabetes was associated with a reduced risk of metastasis (HR=0.73; 95%CI: 0.56-0.94), PCSM (HR= 0.63; 95%CI: 0.45-0.87) and ACM (HR=0.74; 95%CI: 0.58-0.93). Interactions between diabetes and race (White vs. Black men) were not statistically significant for any of the outcomes (p >0.05). CONCLUSIONS: Among men with nmCRPC, we found that diabetes was protective against metastatic disease and mortality. While unexpected, the findings are analogous to studies that have reported diabetes to be protective for PC risk and further suggest a link between diabetes and PC that merit additional investigation. Source of Funding: None © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e254 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Andrei Sergeyev More articles by this author Lin Gu More articles by this author Amanda De Hoedt More articles by this author Christopher Amling More articles by this author William Aronson More articles by this author Matthew Cooperberg More articles by this author Christopher Kane More articles by this author Zachary Klaassen More articles by this author Martha Terris More articles by this author Lourdes Rivera More articles by this author San Juan More articles by this author Puerto Rico More articles by this author Stephen Freedland More articles by this author Ilona Csizmadi More articles by this author Expand All Advertisement PDF downloadLoading ...