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Metabolic syndrome increases the risk of upgrading and upstaging in patients with prostate cancer on biopsy: a radical prostatectomy multicenter cohort study

Prostate Cancer and Prostatic Diseasesvolume 21pages438445 (2018) | Download Citation

  • A Correction to this article was published on 01 February 2019

Abstract

Backround:

Recently metabolic syndrome has been associated to an increased risk of advanced disease. Aim of our study is to investigate the association of metabolic syndrome (MetS) with the risk of prostate cancer (PCa) upgrading and upstaging after radical prostatectomy (RP).

Methods:

From 2012 and 2016, 400 consecutive men underwent RP at three referral centers in Italy and were enrolled into a prospective database. Blood pressure, body mass index and waist circumference were measured before RP. Blood samples were also collected and tested for total PSA, fasting glucose, triglycerides and HDLs. Logistic regression analyses were used to assess the association between MetS, defined according to Adult Treatment Panel III, and the risk of upgrading and upstaging), using the new Prognostic Grade Group (PGG) classification system.

Results:

Overall 148/400 (37%) men were diagnosed with MetS and most of these reported up-grading (54.5%) and up-staging (56.8%). These events were significantly more common in this population and MetS was a risk factor for up-staging and up-grading on multivariable analysis. Patients with MetS presented worst accuracy (72 vs. 84%; p = 0.001) and worst kappa coefficient of agreement (k = 0.439 ± 0.071 vs. k = 0.553 ± 0.071) between needle biopsy and radical prostatectomy specimens when compared to patients without MetS.

Conclusions:

MetS represents a significant risk factor for upgrading and upstaging. Accuracy of PGG system on biopsy is poor in patients with MetS, therefore results should be evaluated carefully in this population.

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Change history

  • 01 February 2019

    The original version of this Article contained an error in the spelling of the authors Cosimo De Nunzio, Aldo Brassetti, Giuseppe Simone, Riccardo Lombardo, Riccardo Mastroianni, Devis Collura, Giovanni Muto, Michele Gallucci and Andrew Tubaro, which were incorrectly given as De Nunzio Cosimo, Brassetti Aldo, Simone Giuseppe, Lombardo Riccardo, Mastroianni Riccardo, Collura Devis, Muto Giovanni, Gallucci Michele and Tubaro Andrea. This has now been corrected in both the PDF and HTML versions of the Article.

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Authors contribution:

DNC conceived and designed the work that led to the submission, acquired data, played an important role in interpreting the results, drafted the manuscript, approved the final version. BA conceived and designed the work that led to the submission, acquired data, played an important role in interpreting the results, drafted the manuscript, approved the final version. SG conceived and designed the work that led to the submission, acquired data, drafted the manuscript, approved the final version. LR conceived and designed the work that led to the submission, acquired data, played an important role in interpreting the results, drafted the manuscript, approved the final version. MR conceived the work that led to the submission, acquired data, revised the manuscript, approved the final version. CD conceived the work that led to the submission, acquired data, revised the manuscript, approved the final version. MG conceived the work that led to the submission, acquired data, revised the manuscript, approved the final version. GM designed the work that led to the submission, acquired data, played an important role in interpreting the results, drafted the manuscript, approved the final version. TA conceived and designed the work that led to the submission, acquired data, played an important role in interpreting the results, drafted the manuscript, approved the final version.

Author information

Affiliations

  1. Department of Urology, Ospedale Sant’Andrea, “La Sapienza” University, Rome, Italy

    • Cosimo De Nunzio
    • , Aldo Brassetti
    • , Riccardo Lombardo
    • , Devis Collura
    • , Michele Gallucci
    •  & Andrea Tubaro
  2. Department of Urology, “Regina Elena” National Cancer Institute, Rome, Italy

    • Giuseppe Simone
    • , Riccardo Mastroianni
    •  & Giovanni Muto
  3. Department of Urology, “San Giovanni Bosco” Hospital, Turin, Italy

    • Giovanni Muto

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Conflict of interest

The authors declare that they have no conflict of interest.

Corresponding author

Correspondence to Cosimo De Nunzio.

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DOI

https://doi.org/10.1038/s41391-018-0054-9