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  • American Association for Cancer Research (AACR)  (5)
  • Aronson, William J.  (5)
  • 1
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    Abstract B72: Metformin use and risk of biochemical recurrence following radical prostatectomy: Results from the SEARCH database
    American Association for Cancer Research (AACR) ; 2012
    In:  Cancer Prevention Research Vol. 5, No. 11_Supplement ( 2012-11-01), p. B72-B72
    Details
    In: Cancer Prevention Research, American Association for Cancer Research (AACR), Vol. 5, No. 11_Supplement ( 2012-11-01), p. B72-B72
    Abstract: Introduction: Metformin is currently the drug of choice for management of type II diabetes mellitus. Recent epidemiological studies have reported that metformin use among diabetics decreases the risk of developing a variety of cancer types, including prostate cancer (PCa). However, the effect of metformin use on PCa outcome has yet to be clarified. The aim of this study was to investigate the association between pre-operative metformin use and biochemical recurrence (BCR) in a cohort of diabetic men who underwent radical prostatectomy (RP). Methods: We performed a retrospective analysis of 337 men from the Shared Equal Access Regional Cancer Hospital (SEARCH) database treated for PCa with RP and with a diagnosis of diabetes prior to surgery. Cox proportional hazard models were used to assess time to BCR for diabetic men taking metformin in the year prior to RP compared to diabetic men not taking metformin. Models were adjusted for age, race, year of surgery, surgical center, pre-operative PSA and biopsy Gleason score. Results: Of 337 diabetic men, 173 (51%) were taking metformin in the year before RP. The median follow-up among men who did not recur was 49 months, during which 112 men (33%) experienced BCR. Metformin use was associated with more recent year of surgery (median 2005 vs. 2001; p & lt;0.001) but not with age, race, BMI or biopsy Gleason score (all p & gt;0.1). Diabetics taking metformin had lower pre-operative PSA (p=0.12) yet higher prostate volume (p=0.17), relative to diabetics not on metformin, though these associations did not reach statistical significance. On unadjusted analyses, metformin use was not significantly associated with BCR (log-rank, p=0.29). After adjusting for multiple pre-operative features, metformin use in the year before surgery remained not related to BCR (HR 0.97, 95% CI 0.59 to 1.60, p=0.912). Conclusion: In this cohort of diabetic men treated for PCa with RP, metformin use in the year prior to surgery was not significantly associated with time to BCR. Although this is the largest study to date to test the role of metformin among diabetics undergoing RP, larger studies with longer follow-up are needed to better assess whether metformin is associated with improved PCa outcomes, though the current study suggested no role for metformin for PCa control. Citation Format: Emma H. Allott, Michael R. Abern, Leah Gerber, Christopher J. Keto, William J. Aronson, Martha K. Terris, Joseph C. Presti, Christopher J. Kane, Christopher L. Amling, Stephen J. Freedland. Metformin use and risk of biochemical recurrence following radical prostatectomy: Results from the SEARCH database. [abstract]. In: Proceedings of the Eleventh Annual AACR International Conference on Frontiers in Cancer Prevention Research; 2012 Oct 16-19; Anaheim, CA. Philadelphia (PA): AACR; Cancer Prev Res 2012;5(11 Suppl):Abstract nr B72.
    Type of Medium: Online Resource
    ISSN: 1940-6207 , 1940-6215
    URL: Article
    DOI: 10.1158/1940-6207.PREV-12-B72
    Language: English
    Publisher: American Association for Cancer Research (AACR)
    Publication Date: 2012
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  • 2
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    Racial Differences in the Association Between Preoperative Serum Cholesterol and Prostate Cancer Recurrence: Results from the SEARCH Database
    American Association for Cancer Research (AACR) ; 2016
    In:  Cancer Epidemiology, Biomarkers & Prevention Vol. 25, No. 3 ( 2016-03-01), p. 547-554
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    In: Cancer Epidemiology, Biomarkers & Prevention, American Association for Cancer Research (AACR), Vol. 25, No. 3 ( 2016-03-01), p. 547-554
    Abstract: Background: Black men are disproportionately affected by both cardiovascular disease and prostate cancer. Epidemiologic evidence linking dyslipidemia, an established cardiovascular risk factor, and prostate cancer progression is mixed. As existing studies were conducted in predominantly non-black populations, research on black men is lacking. Methods: We identified 628 black and 1,020 non-black men who underwent radical prostatectomy and never used statins before surgery in the Shared Equal Access Regional Cancer Hospital (SEARCH) database. Median follow-up was 2.9 years. The impact of preoperative hypercholesterolemia on risk of biochemical recurrence was examined using multivariable, race-stratified proportional hazards. In secondary analysis, we examined associations with low-density lipoprotein (LDL), high-density lipoprotein (HDL), and triglycerides, overall and among men with dyslipidemia. Results: High cholesterol was associated with increased risk of recurrence in black [HRper10 mg/dL 1.06; 95% confidence interval (CI), 1.02–1.11] but not non-black men (HRper10 mg/dL 0.99; 95% CI, 0.95–1.03; Pinteraction = 0.011). Elevated triglycerides were associated with increased risk in both black and non-black men (HRper10 mg/dL 1.02; 95% CI, 1.00–1.03 and 1.02; 95% CI, 1.00–1.02, respectively; Pinteraction = 0.458). There were no significant associations between LDL or HDL and recurrence risk in either race. Associations with cholesterol, LDL, and triglycerides were similar among men with dyslipidemia, but low HDL was associated with increased risk of recurrence in black, but not non-black men with dyslipidemia (Pinteraction = 0.047). Conclusion: Elevated cholesterol was a risk factor for recurrence in black but not non-black men, whereas high triglycerides were associated with increased risk regardless of race. Impact: Significantly contrasting associations by race may provide insight into prostate cancer racial disparities. Cancer Epidemiol Biomarkers Prev; 25(3); 547–54. ©2016 AACR.
    Type of Medium: Online Resource
    ISSN: 1055-9965 , 1538-7755
    URL: Article
    DOI: 10.1158/1055-9965.EPI-15-0876
    Language: English
    Publisher: American Association for Cancer Research (AACR)
    Publication Date: 2016
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  • 3
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    Serum Lipid Profile and Risk of Prostate Cancer Recurrence: Results from the SEARCH Database
    American Association for Cancer Research (AACR) ; 2014
    In:  Cancer Epidemiology, Biomarkers & Prevention Vol. 23, No. 11 ( 2014-11-01), p. 2349-2356
    Details
    In: Cancer Epidemiology, Biomarkers & Prevention, American Association for Cancer Research (AACR), Vol. 23, No. 11 ( 2014-11-01), p. 2349-2356
    Abstract: Background: Evidence for an association between total cholesterol, low- and high-density lipoproteins (LDL and HDL, respectively), triglycerides, and prostate cancer is conflicting. Given that prostate cancer and dyslipidemia affect large proportions of Western society, understanding these associations has public health importance. Methods: We conducted a retrospective cohort analysis of 843 radical prostatectomy (RP) patients who never used statins before surgery within the Shared Equal Access Regional Cancer Hospital (SEARCH) database. Multivariable Cox proportional hazards analysis was used to investigate the association between cholesterol, LDL, HDL, and triglycerides and biochemical recurrence risk. In secondary analysis, we explored these associations in patients with dyslipidemia, defined using National Cholesterol Education Program guidelines. Results: Elevated serum triglycerides were associated with increased risk of prostate cancer recurrence [HRper 10 mg/dl, 1.03; 95% confidence interval (CI), 1.01–1.05] but associations between total cholesterol, LDL and HDL, and recurrence risk were null. However, among men with dyslipidemia, each 10 mg/dl increase in cholesterol and HDL was associated with 9% increased recurrence risk (HR, 1.09; 95% CI, 1.01–1.17) and 39% reduced recurrence risk (HR, 0.61; 95% CI, 0.41–0.91), respectively. Conclusions: Elevated serum triglycerides were associated with increased risk of prostate cancer recurrence. Cholesterol, LDL, or HDL were not associated with recurrence risk among all men. However, among men with dyslipidemia, elevated cholesterol and HDL levels were associated with increased and decreased risk of recurrence, respectively. Impact: These findings, coupled with evidence that statin use is associated with reduced recurrence risk, suggest that lipid levels should be explored as a modifiable risk factor for prostate cancer recurrence. Cancer Epidemiol Biomarkers Prev; 23(11); 2349–56. ©2014 AACR.
    Type of Medium: Online Resource
    ISSN: 1055-9965 , 1538-7755
    URL: Article
    DOI: 10.1158/1055-9965.EPI-14-0458
    Language: English
    Publisher: American Association for Cancer Research (AACR)
    Publication Date: 2014
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  • 4
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    Diabetes and Prostate Cancer Outcomes in Men with Nonmetastatic Castration-Resistant Prostate Cancer: Results from the SEARCH Cohort
    American Association for Cancer Research (AACR) ; 2023
    In:  Cancer Epidemiology, Biomarkers & Prevention Vol. 32, No. 9 ( 2023-09-01), p. 1208-1216
    Details
    In: Cancer Epidemiology, Biomarkers & Prevention, American Association for Cancer Research (AACR), Vol. 32, No. 9 ( 2023-09-01), p. 1208-1216
    Abstract: The prognosis of diabetic men with advanced prostate cancer is poorly understood and understudied. Hence, we studied associations between diabetes and progression to metastases, prostate cancer–specific mortality (PCSM) and all-cause mortality (ACM) in men with nonmetastatic castration-resistant prostate cancer (nmCRPC). Methods: Data from men diagnosed with nmCRPC between 2000 and 2017 at 8 Veterans Affairs Health Care Centers were analyzed using Cox regression to determine HRs and 95% confidence intervals (CI) for associations between diabetes and outcomes. Men with diabetes were classified according to: (i) ICD-9/10 codes only, (ii) two HbA1c values & gt; 6.4% (missing ICD-9/10 codes), and (iii) all diabetic men [(i) and (ii) combined]. Results: Of 976 men (median age: 76 years), 304 (31%) had diabetes at nmCRPC diagnosis, of whom 51% had ICD-9/10 codes. During a median follow-up of 6.5 years, 613 men were diagnosed with metastases, and 482 PCSM and 741 ACM events occurred. In multivariable-adjusted models, ICD-9/10 code-identified diabetes was inversely associated with PCSM (HR, 0.67; 95% CI, 0.48–0.92) while diabetes identified by high HbA1c values (no ICD-9/10 codes) was associated with an increase in ACM (HR, 1.41; 95% CI, 1.16–1.72). Duration of diabetes, prior to CRPC diagnosis was inversely associated with PCSM among men identified by ICD-9/10 codes and/or HbA1c values (HR, 0.93; 95% CI, 0.88–0.98). Conclusions: In men with late-stage prostate cancer, ICD-9/10 ‘code-identified’ diabetes is associated with better overall survival than ‘undiagnosed’ diabetes identified by high HbA1c values only. Impact: Our data suggest that better diabetes detection and management may improve survival in late-stage prostate cancer.
    Type of Medium: Online Resource
    ISSN: 1055-9965 , 1538-7755
    URL: Article
    DOI: 10.1158/1055-9965.EPI-22-1324
    Language: English
    Publisher: American Association for Cancer Research (AACR)
    Publication Date: 2023
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    detail.hit.zdb_id: 1153420-5
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  • 5
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    Abstract 880: Obesity predicts prostate cancer-specific mortality after radical prostatectomy: Results from the SEARCH database
    American Association for Cancer Research (AACR) ; 2015
    In:  Cancer Research Vol. 75, No. 15_Supplement ( 2015-08-01), p. 880-880
    Details
    In: Cancer Research, American Association for Cancer Research (AACR), Vol. 75, No. 15_Supplement ( 2015-08-01), p. 880-880
    Abstract: INTRODUCTION: At the population level among otherwise “healthy” men, obesity is associated with prostate cancer mortality. However, few studies analyzed the associations between obesity and long-term progression after surgery, such as castration-resistant prostate cancer (CRPC) and prostate cancer-specific mortality (PCSM). We examined the effect of obesity at the time of radical prostatectomy (RP) on long-term prostate cancer-specific outcomes among men treated at Veterans Affairs Hospitals in the USA. METHODS: We combined data from patients undergoing RP at six Veterans Affairs Medical Centers (West Los Angeles, San Diego, and Palo Alto, CA; Augusta, GA; and Durham and Asheville, NC) into the SEARCH database. Our exposure, body mass index (BMI) was abstracted from the medical records at the time of but prior to RP and categorized as normal weight ( & lt;25 kg/m2), overweight (25-29.9kg/m2), and obese (≥30kg/m2). Crude and adjusted Cox models accounting for known risk cofactors were used to examine the associations between BMI and PCSM (primary outcome), biochemical recurrence (BCR) and CRPC. Hazard ratios for the risk of CRPC and PCSM were analyzed using competing-risks regression analysis accounting for non-PC death as a competing risk. RESULTS: Overall, 839 (23%) men had normal weight, 1,675 (45%) were overweight, and 1,184 (32%) were obese. A higher BMI was associated with younger age at surgery (p & lt;0.001), lower PSA (median 6.9 vs. 6.3 vs. 6.1; p & lt;0.001), and a shorter follow-up (p = 0.009). After adjusting for clinical and pathological features, both overweight (HR 2.85, p = 0.039) and obesity (HR 3.38, p = 0.017) were significantly associated with PCSM relative to normal weight. Obesity (vs. normal weight) was also associated with a higher risk of BCR (HR = 1.20, p = 0.026) and CRPC (HR = 2.12, p = 0.026), even after adjusting for clinical and pathological characteristics. Overweight was not associated with BCR (HR = 1.01, p = 0.948) or CRPC (HR = 1.44, p = 0.274) on multivariable analysis. CONCLUSIONS: Our study supports the hypothesis that obese men undergoing RP are at increased risk of worse long-term prostate cancer outcomes including PCSM. Our findings are consistent with a growing body of literature documenting that obesity in general is associated with more aggressive prostate cancer. Citation Format: Adriana C. Vidal, Lauren E. Howard, Matthew R Cooperberg, Christopher J. Kane, William J. Aronson, Martha K. Terris, Christopher L. Amling, Stephen J Freedland. Obesity predicts prostate cancer-specific mortality after radical prostatectomy: Results from the SEARCH database. [abstract]. In: Proceedings of the 106th Annual Meeting of the American Association for Cancer Research; 2015 Apr 18-22; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Res 2015;75(15 Suppl):Abstract nr 880. doi:10.1158/1538-7445.AM2015-880
    Type of Medium: Online Resource
    ISSN: 0008-5472 , 1538-7445
    URL: Article
    DOI: 10.1158/1538-7445.AM2015-880
    RVK:
    XA 36000
    RVK:
    XA 10000
    Language: English
    Publisher: American Association for Cancer Research (AACR)
    Publication Date: 2015
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