ABSTRACT
INTRODUCTION: Metabolic syndrome (MS) is linked to hormone-dependent cancers. Its prognostic implication in prostate cancer (PCa) is unclear. We analyzed the impact of MS in the survival of men with PCa treated surgically. PATIENTS AND METHODS: We studied patients with PCa, treated surgically between 1990 and 2007, and compared the survival of men with MS (group 1) and without MS (group 2). A subgroup analysis of those in stage pT2 was also performed. We calculated biochemical progression-free survival (bPFS) and cancer-specific survival, and the relation of clinical and pathological variables with these end-points. RESULTS: 65 men had MS. The 5- and 10-year bPFS in group 1 was 36 and 32% vs. 72 and 68% in group 2 (p < 0.0001). In multivariate analysis, prostate-specific antigen (p = 0.001) and MS (p < 0.0001) predicted biochemical progression/recurrence (BP/R). There was no difference in cancer-specific survival between groups (p = 0.40). Of 146 men in stage pT2, 38 had MS; group 1 men had worse 5- and 10-year bPFS (55 and 48%) than group 2 (80 and 73%; p = 0.001). In multivariate analysis, MS was the strongest predictor of BP/R (p = 0.0007). CONCLUSIONS: MS is related to adverse characteristics in PCa and confers poor bPFS after radical prostatectomy. MS is independently associated to the risk of BP/R.
Subject(s)
Metabolic Syndrome/complications , Prostatectomy/methods , Prostatic Neoplasms/complications , Prostatic Neoplasms/surgery , Adult , Aged , Cohort Studies , Disease Progression , Disease-Free Survival , Female , Humans , Male , Middle Aged , Multivariate Analysis , Prognosis , Prostatic Neoplasms/diagnosis , Recurrence , Time Factors , Treatment OutcomeABSTRACT
OBJECTIVE: To evaluate the prognostic impact of early recurrence (within 12 months) after surgery on cancer-specific survival (CSS) of patients with localized clear-cell renal cell carcinoma (ccRCC). METHODS: Patients with surgically treated localized ccRCC were studied. Using the Kaplan-Meier method, we calculated CSS; by univariate and multivariate models we analyzed the association of early recurrence with cancer-related mortality. RESULTS: We identified 259 patients with pT1-4/NX/0M0 ccRCC treated between February 1981 and September 2009; of 66 (25.5%) with disease recurrence, 29 (43.9%) had early relapse. Overall, 43 patients (16.6%) died from ccRCC. The 5- and 10-year CSS for those without, late and early recurrence was 98.5 and 96.5%, 53 and 39.8%, and 23 and 23%, respectively (p < 0.0001). In the multivariate Cox model, pT stage (p = 0.01) and early recurrence (p < 0.0001) independently predicted CSS. CONCLUSIONS: Recurrent disease after localized ccRCC confers a poor prognosis, especially if detected within 12 months after surgery. Thus, this criterion should be included as an independent risk factor for cancer-related mortality.
