Impact of Diabetes on Clinical Outcomes of Prostate Cancer

Objectives: Diabetes is both a risk factor associated with increased incidence and a prognostic determinant for various cancer types. This study aimed to evaluate the impact of diabetes on prostate cancer outcomes.

Methods: The study included patients diagnosed with prostate cancer either at non metastatic stage at diagnosis and later developed metastasis or at metastatic stage at diagnosis. The characteristics of disease including patient age, date of diagnosis, gleason score (GS), stage, PSA level, time-to-distant metastasis for non-metastatic disease at diagnosis and time-to-castration resistance for metastatic disease, presence of diabetes, last date of control were reviewed retrospectively.

Results: A total of 149 patients were included in the study. Median overall survival of patients with diabetes was 32 months whereas it was 66 months for those without diabetes (HR=2; 95% CI: 1.33–3; p=0.001). For non-metastatic disease at diagnosis, median time-to-distant metastasis was 48 months for those with diabetes, and 63 months for those without (p=0.13). Median time-to-castration resistance was 12 months vs. 27 months for patients with diabetes and without diabetes (HR=3.66; 95% CI: 2.46–5.45; p=0.000).

Conclusion: Presence of diabetes is a robust and reliable prognostic marker for predicting poor survival outcomes including time-to-distant metastasis, time-to-castration resistance and overall survival in prostate cancer.