title: Diabetes and beta-adrenergic blockage are risk factors for metastatic prostate cancer.
abstract: BACKGROUND
  We evaluated the influence of comorbidity inferred risks for lymph node metastasis (pN1) and positive surgical margins (R1) after radical prostatectomy in order to optimize pretherapeutic risk classification. We analyzed 454 patients after radical prostatectomy (RP) between 2009 and 2014. Comorbidities were defined by patients' medication from our electronic patient chart and stratified according to the ATC WHO code. Endpoints were lymph node metastasis (pN1) and positive surgical margins (R1).
  
  
  RESULTS
  Rates for pN1 and R1 were 21.4% (97/454) and 29.3% (133/454), respectively. In addition to CAPRA and Gleason score, we identified diabetes as a significant medication inferred risk factor for pN1 (OR 2.9, p = 0.004/OR 3.2, p = 0.001/OR 3.5, p = 0.001) and beta-blockers for R1 (OR 1.9, p = 0.020/OR 2.9, p = 0.004). Patients with diabetes showed no statistically significant difference in Gleason score, CAPRA Score, PSA, and age compared to non-diabetic patients.
  
  
  CONCLUSIONS
  We identified diabetes and beta1 adrenergic blockage as significant risk factors for lymph node metastasis and positive surgical margins in prostate cancer (PCa). Patients at risk will need intensive pretherapeutic staging for optimal therapeutic stratification.
authors.affiliation: Department of Urology, Uniklinikum Freiburg, Hugstetter Strasse 55, 79106, Freiburg, Germany. malte.kroenig@uniklinik-freiburg.de.|Department of Urology, University of Freiburg Medical Centre, Hugstetter Strasse 55, 79106, Freiburg, Germany. malte.kroenig@uniklinik-freiburg.de.
authors.forename: Malte
authors.identifier: http://orcid.org/0000-0003-0787-992X
authors.initials: M
authors.lastname: Krönig
authors.affiliation: IT-Department, Uniklinikum Freiburg, Agnesenstrasse 6-8, 79106, Freiburg, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Haverkamp
authors.affiliation: Department of Urology, Uniklinikum Freiburg, Hugstetter Strasse 55, 79106, Freiburg, Germany.
authors.forename: Antonia
authors.initials: A
authors.lastname: Schulte
authors.affiliation: Department of Urology, Uniklinikum Freiburg, Hugstetter Strasse 55, 79106, Freiburg, Germany.
authors.forename: Laura
authors.initials: L
authors.lastname: Heinicke
authors.affiliation: Department of Urology, Uniklinikum Freiburg, Hugstetter Strasse 55, 79106, Freiburg, Germany.
authors.forename: Kathrin
authors.initials: K
authors.lastname: Schaal
authors.affiliation: Institut of Clinical Pathology, Uniklinikum Freiburg, Breisacher Strasse 115a, 79106, Freiburg, Germany.
authors.forename: Vanessa
authors.initials: V
authors.lastname: Drendel
authors.affiliation: Institut of Clinical Pathology, Uniklinikum Freiburg, Breisacher Strasse 115a, 79106, Freiburg, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Werner
authors.affiliation: Department of Urology, Uniklinikum Freiburg, Hugstetter Strasse 55, 79106, Freiburg, Germany.
authors.forename: Ulrich
authors.initials: U
authors.lastname: Wetterauer
authors.affiliation: Department of Urology, Uniklinikum Freiburg, Hugstetter Strasse 55, 79106, Freiburg, Germany.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Schultze-Seemann
authors.affiliation: Department of Urology, Uniklinikum Freiburg, Hugstetter Strasse 55, 79106, Freiburg, Germany.
authors.forename: Cordula Annette
authors.initials: CA
authors.lastname: Jilg
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000009:adverse effects*; D000368:Aged; D003131:Combined Modality Therapy; D003920:Diabetes Mellitus / Q000503:physiopathology*; D005500:Follow-Up Studies; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D011379:Prognosis; D011468:Prostatectomy / Q000009:adverse effects; D011471:Prostatic Neoplasms / Q000209:etiology* / Q000556:secondary* / Q000601:surgery
chemical_list: D000319:Adrenergic beta-Antagonists
keywords: Beta-adrenergic blockage; Diabetes; Metastasis; Prostate cancer