Presence of the metabolic syndrome is associated with shorter time to castration-resistant prostate cancer.
BACKGROUND
Metabolic syndrome (MS) is a set of risk factors that includes obesity and insulin resistance and has been implicated in the development of prostate cancer. Its impact on androgen deprivation therapy (ADT) efficacy has not been studied.


METHODS
Retrospective study of prostate cancer patients seen from 1998 to 2005 in a medical oncology clinic. MS, as defined by modified Adult Treatment Panel III criteria, was assessed at the time of initiation of ADT. The study end points were time to prostate-specific antigen (PSA) progression and overall survival (OS) from time of starting ADT.


RESULTS
Eighty-two patients treated with ADT and data to assess for presence of MS were identified. Median age in men with and without MS was 70 years and 49% of the patients evaluated met criteria for MS. Median time to PSA progression for patients with MS was 16 versus 36 months without MS (P=0.003). The median OS for patients with MS was 36.5 months after commencing ADT compared with 46.7 months for those patients without MS (P=0.061).


CONCLUSIONS
This preliminary data suggest that MS is a risk factor for earlier development of castration-resistant prostate cancer and support the need for a prospective evaluation of this finding.
Flanagan
J
J
Division of Hematology/Oncology, Department of Medicine, Indiana University School of Medicine, Indianapolis; Kansas City Cancer Center, US Oncology, Kansas City.
Gray
P Kathryn
PK
Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute, Harvard School of Public Health, Boston.
Hahn
N
N
Division of Hematology/Oncology, Department of Medicine, Indiana University School of Medicine, Indianapolis.
Hayes
J
J
Department of Medicine, Dana Farber Cancer Institute, Boston.
Myers
L J
LJ
Division of General Internal Medicine and Geriatrics, Department of Medicine, Indiana University School of Medicine, Indianapolis; Health Services Research and Development Center of Excellence on Implementing Evidence-Based Practice (CIEBP), Roudebush VA Medical Center, Indianapolis.
Carney-Doebbeling
C
C
Division of Hematology/Oncology, Department of Medicine, Indiana University School of Medicine, Indianapolis; Regenstrief Institute Inc, Indianapolis, USA.
Sweeney
C J
CJ
Division of Hematology/Oncology, Department of Medicine, Indiana University School of Medicine, Indianapolis; Department of Medicine, Dana Farber Cancer Institute, Boston. Electronic address: christopher_sweeney@dfci.harvard.edu.
D000368:Aged; D000369:Aged, 80 and over; D000726:Androgen Antagonists / Q000009:adverse effects / Q000627:therapeutic use*; D000728:Androgens; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D024821:Metabolic Syndrome / Q000139:chemically induced*; D008875:Middle Aged; D009919:Orchiectomy; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000097:blood / Q000628:therapy*; D012189:Retrospective Studies; D012307:Risk Factors
D000726:Androgen Antagonists; D000728:Androgens; D017430:Prostate-Specific Antigen