Association among metabolic syndrome, inflammation, and survival in prostate cancer

Vincenza Conteduca, Orazio Caffo, Luca Galli, Antonio Maugeri, Emanuela Scarpi, Francesca Maines, Vincenzo Emanuele Chiuri, Cristian Lolli, Stefania Kinspergher, Giuseppe Schepisi, Matteo Santoni, Daniele Santini, Lucia Fratino, Salvatore Luca Burgio, Samanta Salvi, Cecilia Menna, Ugo De Giorgi

Research output: Contribution to journalArticle

Abstract

Background: Metabolic syndrome (MS) and inflammation (INF) alterations are among the factors involved in cancer progression. The study aimed to assess the relationship between MS and INF and its effect on progression-free/overall survival (PFS/OS) in metastatic castration-resistant prostate cancer (mCRPC) treaed with abiraterone or enzalutamide. Methods: We, retrospectively, evaluated patients with mCRPC in 7 Italian Institutes between March 2011 and October 2016. MS was defined by modified adult treatment panel-III criteria. INF was characterized by at least one of these criteria: neutrophil to lymphocyte ratio ≥ 3, elevated erythrocyte sedimentation rate or C-reactive protein. Results: Eighty-three of 551 (15.1%) patients met MS criteria at baseline and 34 (6.2%) during treatment. MS patients (MS+) presented a greater INF profile compared to MS− (P<0.0001). Median PFS was 3.7 for MS+ vs. 8.7 months for MS− (hazard ratio [HR] = 2.77; 95% CI: 2.12–3.61; P<0.0001). Median OS was 6.9 and 19 months in MS+ and MS−, respectively (HR = 3.43; 95% CI: 2.56–4.58; P<0.0001). We also demonstrated INF led to shorter PFS and OS (4.5 vs. 8.5 months, HR = 1.48, 95% CI: 1.15–1.90, P = 0.002, and 11.2 vs. 18.8 months, HR =1.66, 95% CI: 1.26–2.18, P = 0.0003, respectively). The combination of MS with INF provided the identification of high-risk prognostic group (MS+/INF+ vs. MS−/INF−) with worse PFS (3.7 vs. 9 months, HR = 2.7, 95% CI: 1.88–3.89, P<0.0001) and OS (6.3 vs. 20.4 months, HR = 4.04, 95% CI: 2.75–5.93, P<0.0001). Multivariable analysis confirmed that MS was independently associated with PFS (HR = 2.07; 95% CI: 1.03–4.18; P = 0.041) and OS (HR = 4.87; 95% CI: 2.36–10.03; P<0.0001). The absence of INF as an independent predictor of survival underlined the correlation between MS/INF. Conclusions: Pretreatment identification of MS and INF alterations might represent an available and easy tool for better prognostication of patients with mCRPC. A prospective evaluation is warranted.

Original languageEnglish
Pages (from-to)240.e1-240.e11
JournalUrologic Oncology: Seminars and Original Investigations
Volume36
Issue number5
DOIs
Publication statusPublished - May 1 2018

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Prostatic Neoplasms
Inflammation
Survival
Castration
Blood Sedimentation
C-Reactive Protein
Disease-Free Survival
Neutrophils

Keywords

  • Abiraterone
  • Castration-resistant prostate cancer
  • Enzalutamide
  • Inflammation
  • Metabolic syndrome

ASJC Scopus subject areas

  • Oncology
  • Urology

Cite this

Association among metabolic syndrome, inflammation, and survival in prostate cancer. / Conteduca, Vincenza; Caffo, Orazio; Galli, Luca; Maugeri, Antonio; Scarpi, Emanuela; Maines, Francesca; Chiuri, Vincenzo Emanuele; Lolli, Cristian; Kinspergher, Stefania; Schepisi, Giuseppe; Santoni, Matteo; Santini, Daniele; Fratino, Lucia; Burgio, Salvatore Luca; Salvi, Samanta; Menna, Cecilia; De Giorgi, Ugo.

In: Urologic Oncology: Seminars and Original Investigations, Vol. 36, No. 5, 01.05.2018, p. 240.e1-240.e11.

Research output: Contribution to journalArticle

Conteduca, Vincenza ; Caffo, Orazio ; Galli, Luca ; Maugeri, Antonio ; Scarpi, Emanuela ; Maines, Francesca ; Chiuri, Vincenzo Emanuele ; Lolli, Cristian ; Kinspergher, Stefania ; Schepisi, Giuseppe ; Santoni, Matteo ; Santini, Daniele ; Fratino, Lucia ; Burgio, Salvatore Luca ; Salvi, Samanta ; Menna, Cecilia ; De Giorgi, Ugo. / Association among metabolic syndrome, inflammation, and survival in prostate cancer. In: Urologic Oncology: Seminars and Original Investigations. 2018 ; Vol. 36, No. 5. pp. 240.e1-240.e11.
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title = "Association among metabolic syndrome, inflammation, and survival in prostate cancer",
abstract = "Background: Metabolic syndrome (MS) and inflammation (INF) alterations are among the factors involved in cancer progression. The study aimed to assess the relationship between MS and INF and its effect on progression-free/overall survival (PFS/OS) in metastatic castration-resistant prostate cancer (mCRPC) treaed with abiraterone or enzalutamide. Methods: We, retrospectively, evaluated patients with mCRPC in 7 Italian Institutes between March 2011 and October 2016. MS was defined by modified adult treatment panel-III criteria. INF was characterized by at least one of these criteria: neutrophil to lymphocyte ratio ≥ 3, elevated erythrocyte sedimentation rate or C-reactive protein. Results: Eighty-three of 551 (15.1{\%}) patients met MS criteria at baseline and 34 (6.2{\%}) during treatment. MS patients (MS+) presented a greater INF profile compared to MS− (P<0.0001). Median PFS was 3.7 for MS+ vs. 8.7 months for MS− (hazard ratio [HR] = 2.77; 95{\%} CI: 2.12–3.61; P<0.0001). Median OS was 6.9 and 19 months in MS+ and MS−, respectively (HR = 3.43; 95{\%} CI: 2.56–4.58; P<0.0001). We also demonstrated INF led to shorter PFS and OS (4.5 vs. 8.5 months, HR = 1.48, 95{\%} CI: 1.15–1.90, P = 0.002, and 11.2 vs. 18.8 months, HR =1.66, 95{\%} CI: 1.26–2.18, P = 0.0003, respectively). The combination of MS with INF provided the identification of high-risk prognostic group (MS+/INF+ vs. MS−/INF−) with worse PFS (3.7 vs. 9 months, HR = 2.7, 95{\%} CI: 1.88–3.89, P<0.0001) and OS (6.3 vs. 20.4 months, HR = 4.04, 95{\%} CI: 2.75–5.93, P<0.0001). Multivariable analysis confirmed that MS was independently associated with PFS (HR = 2.07; 95{\%} CI: 1.03–4.18; P = 0.041) and OS (HR = 4.87; 95{\%} CI: 2.36–10.03; P<0.0001). The absence of INF as an independent predictor of survival underlined the correlation between MS/INF. Conclusions: Pretreatment identification of MS and INF alterations might represent an available and easy tool for better prognostication of patients with mCRPC. A prospective evaluation is warranted.",
keywords = "Abiraterone, Castration-resistant prostate cancer, Enzalutamide, Inflammation, Metabolic syndrome",
author = "Vincenza Conteduca and Orazio Caffo and Luca Galli and Antonio Maugeri and Emanuela Scarpi and Francesca Maines and Chiuri, {Vincenzo Emanuele} and Cristian Lolli and Stefania Kinspergher and Giuseppe Schepisi and Matteo Santoni and Daniele Santini and Lucia Fratino and Burgio, {Salvatore Luca} and Samanta Salvi and Cecilia Menna and {De Giorgi}, Ugo",
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doi = "10.1016/j.urolonc.2018.01.007",
language = "English",
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TY - JOUR

T1 - Association among metabolic syndrome, inflammation, and survival in prostate cancer

AU - Conteduca, Vincenza

AU - Caffo, Orazio

AU - Galli, Luca

AU - Maugeri, Antonio

AU - Scarpi, Emanuela

AU - Maines, Francesca

AU - Chiuri, Vincenzo Emanuele

AU - Lolli, Cristian

AU - Kinspergher, Stefania

AU - Schepisi, Giuseppe

AU - Santoni, Matteo

AU - Santini, Daniele

AU - Fratino, Lucia

AU - Burgio, Salvatore Luca

AU - Salvi, Samanta

AU - Menna, Cecilia

AU - De Giorgi, Ugo

PY - 2018/5/1

Y1 - 2018/5/1

N2 - Background: Metabolic syndrome (MS) and inflammation (INF) alterations are among the factors involved in cancer progression. The study aimed to assess the relationship between MS and INF and its effect on progression-free/overall survival (PFS/OS) in metastatic castration-resistant prostate cancer (mCRPC) treaed with abiraterone or enzalutamide. Methods: We, retrospectively, evaluated patients with mCRPC in 7 Italian Institutes between March 2011 and October 2016. MS was defined by modified adult treatment panel-III criteria. INF was characterized by at least one of these criteria: neutrophil to lymphocyte ratio ≥ 3, elevated erythrocyte sedimentation rate or C-reactive protein. Results: Eighty-three of 551 (15.1%) patients met MS criteria at baseline and 34 (6.2%) during treatment. MS patients (MS+) presented a greater INF profile compared to MS− (P<0.0001). Median PFS was 3.7 for MS+ vs. 8.7 months for MS− (hazard ratio [HR] = 2.77; 95% CI: 2.12–3.61; P<0.0001). Median OS was 6.9 and 19 months in MS+ and MS−, respectively (HR = 3.43; 95% CI: 2.56–4.58; P<0.0001). We also demonstrated INF led to shorter PFS and OS (4.5 vs. 8.5 months, HR = 1.48, 95% CI: 1.15–1.90, P = 0.002, and 11.2 vs. 18.8 months, HR =1.66, 95% CI: 1.26–2.18, P = 0.0003, respectively). The combination of MS with INF provided the identification of high-risk prognostic group (MS+/INF+ vs. MS−/INF−) with worse PFS (3.7 vs. 9 months, HR = 2.7, 95% CI: 1.88–3.89, P<0.0001) and OS (6.3 vs. 20.4 months, HR = 4.04, 95% CI: 2.75–5.93, P<0.0001). Multivariable analysis confirmed that MS was independently associated with PFS (HR = 2.07; 95% CI: 1.03–4.18; P = 0.041) and OS (HR = 4.87; 95% CI: 2.36–10.03; P<0.0001). The absence of INF as an independent predictor of survival underlined the correlation between MS/INF. Conclusions: Pretreatment identification of MS and INF alterations might represent an available and easy tool for better prognostication of patients with mCRPC. A prospective evaluation is warranted.

AB - Background: Metabolic syndrome (MS) and inflammation (INF) alterations are among the factors involved in cancer progression. The study aimed to assess the relationship between MS and INF and its effect on progression-free/overall survival (PFS/OS) in metastatic castration-resistant prostate cancer (mCRPC) treaed with abiraterone or enzalutamide. Methods: We, retrospectively, evaluated patients with mCRPC in 7 Italian Institutes between March 2011 and October 2016. MS was defined by modified adult treatment panel-III criteria. INF was characterized by at least one of these criteria: neutrophil to lymphocyte ratio ≥ 3, elevated erythrocyte sedimentation rate or C-reactive protein. Results: Eighty-three of 551 (15.1%) patients met MS criteria at baseline and 34 (6.2%) during treatment. MS patients (MS+) presented a greater INF profile compared to MS− (P<0.0001). Median PFS was 3.7 for MS+ vs. 8.7 months for MS− (hazard ratio [HR] = 2.77; 95% CI: 2.12–3.61; P<0.0001). Median OS was 6.9 and 19 months in MS+ and MS−, respectively (HR = 3.43; 95% CI: 2.56–4.58; P<0.0001). We also demonstrated INF led to shorter PFS and OS (4.5 vs. 8.5 months, HR = 1.48, 95% CI: 1.15–1.90, P = 0.002, and 11.2 vs. 18.8 months, HR =1.66, 95% CI: 1.26–2.18, P = 0.0003, respectively). The combination of MS with INF provided the identification of high-risk prognostic group (MS+/INF+ vs. MS−/INF−) with worse PFS (3.7 vs. 9 months, HR = 2.7, 95% CI: 1.88–3.89, P<0.0001) and OS (6.3 vs. 20.4 months, HR = 4.04, 95% CI: 2.75–5.93, P<0.0001). Multivariable analysis confirmed that MS was independently associated with PFS (HR = 2.07; 95% CI: 1.03–4.18; P = 0.041) and OS (HR = 4.87; 95% CI: 2.36–10.03; P<0.0001). The absence of INF as an independent predictor of survival underlined the correlation between MS/INF. Conclusions: Pretreatment identification of MS and INF alterations might represent an available and easy tool for better prognostication of patients with mCRPC. A prospective evaluation is warranted.

KW - Abiraterone

KW - Castration-resistant prostate cancer

KW - Enzalutamide

KW - Inflammation

KW - Metabolic syndrome

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