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Association between type 2 diabetes, curative treatment and survival in men with intermediate‐ and high‐risk localized prostate cancer
Author(s) -
Crawley Danielle,
Garmo Hans,
Rudman Sarah,
Stattin Pär,
Zethelius Björn,
Holmberg Lars,
Adolfsson Jan,
Van Hemelrijck Mieke
Publication year - 2018
Publication title -
bju international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 1464-4096
DOI - 10.1111/bju.13880
Subject(s) - medicine , prostate cancer , confidence interval , odds ratio , prostate specific antigen , logistic regression , prostate , diabetes mellitus , cancer , urology , oncology , gynecology , endocrinology
Objective To investigate whether curative prostate cancer ( PC a) treatment was received less often by men with both PC a and Type 2 diabetes mellitus (T2 DM ) as little is known about the influence of T2 DM diagnosis on the receipt of such treatment in men with localized PC a. Subjects and Methods The Prostate Cancer database Sweden ( PCB aSe) was used to obtain data on men with T2 DM and PC a ( n = 2210) for comparison with data on men with PC a only ( n = 23 071). All men had intermediate‐ (T1–2, Gleason score 7 and/or prostate‐specific antigen [ PSA ] 10–20 ng/mL) or high‐risk (T3 and/or Gleason score 8–10 and/or PSA 20–50 ng/ mL ) localized PC a diagnosed between 1 January 2006 and 31 December 2014. Multivariate logistic regression was used to calculate the odds ratios ( OR s) for receipt of curative treatment in men with and without T2 DM . Overall survival, for up to 8 years of follow‐up, was calculated both for men with T2 DM only and for men with T2 DM and PC a. Results Men with T2 DM were less likely to receive curative treatment for PC a than men without T2 DM ( OR 0.78, 95% confidence interval 0.69–0.87). The 8‐year overall survival rates were 79% and 33% for men with T2 DM and high‐risk PC a who did and did not receive curative treatment, respectively. Conclusions Men with T2 DM were less likely to receive curative treatment for localized intermediate‐ and high‐risk PC a. Men with T2 DM and high‐risk PC a who received curative treatment had substantially higher survival times than those who did not. Some of the survival differences represent a selection bias, whereby the healthiest patients received curative treatment. Clinicians should interpret this data carefully and ensure that individual patients with T2 DM and PC a are not under‐ nor overtreated.