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Basic Research

Does pre-existing diabetes affect prostate cancer prognosis? A systematic review

Abstract

To summarize the influence of pre-existing diabetes on mortality and morbidity in men with prostate cancer. We searched MEDLINE and EMBASE from inception through 1 October 2008. Search terms were related to diabetes, cancer and prognosis. Studies were included if they reported an original data analysis of prostate cancer prognosis, compared outcomes between men with and without diabetes and were in English. Titles, abstracts and articles were reviewed independently by two authors. Conflicts were settled by consensus or third review. We abstracted data on study design, analytic methods, outcomes and quality. We summarized mortality and morbidity outcomes qualitatively and conducted a preliminary meta-analysis to quantify the risk of long-term (>3 months), overall mortality. In total, 11 articles were included in the review. Overall, one of four studies found increased prostate cancer mortality, one of two studies found increased nonprostate cancer mortality and one study found increased 30-day mortality. Data from four studies could be included in a preliminary meta-analysis for long-term, overall mortality and produced a pooled hazard ratio of 1.57 (95% CI: 1.12–2.20). Diabetes was also associated with receiving radiation therapy, complication rates, recurrence and treatment failure. Our analysis suggests that pre-existing diabetes affects the treatment and outcomes of men with prostate cancer.

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Acknowledgements

Dr Snyder is supported by a Mentored Research Scholar Grant from the American Cancer Society (MRSG-08-011-01-CPPB). Ms Barone and Dr Derr are supported by the NIDDK Diabetes and Obesity Training Grant (T32 DK062707). Dr Stein is supported by a NIH fellowship from Health Services and Administration (T32HP10025-14). Dr Brancati is supported by the NIDDK Patient Oriented Research in Type 2 Diabetes Grants (K24-DK62222). Drs Yeh and Brancati are supported by the NIDDK Diabetes Research and Training Center (P60 DK079637). No funding body had a role in study design, data collection, analysis or reporting.

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Correspondence to C F Snyder.

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Snyder, C., Stein, K., Barone, B. et al. Does pre-existing diabetes affect prostate cancer prognosis? A systematic review. Prostate Cancer Prostatic Dis 13, 58–64 (2010). https://doi.org/10.1038/pcan.2009.39

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