Risk Analysis of Prostate Cancer Treatments in Promoting Metabolic Syndrome Development and the Influence of Increased Metabolic Syndrome on Prostate Cancer Therapeutic Outcome.

Abstract

In clinical practice, few prostate cancer (PCa) patients are associated with metabolic syndrome (MetS), while few others acquire MetS during treatment. Whether the treatment of PCa increases the occurrence of MetS remains to be confirmed. This study reviewed the changes in MetS patients before and after PCa treatment to evaluate the effects of various treatment methods on MetS. We analyzed data of 1162 PCa patients, whether or not diagnosed with MetS, and changes in MetS patients after PCa treatment. Data of lower urinary tract symptoms, C-reactive protein (CRP), platelet distribution width (PDW), prostate-specific antigen (PSA), Gleason score, clinical stage, treatment methods, and progressive incidents were evaluated using logistic regression according to MetS diagnosis. The results showed significant differences in the prevalence of MetS before (17.38%) and after (23.67%) PCa treatment (P < 0.001). Bad diet, living habits, and prostate cancer treatment were considered as risk factors for MetS (OR = 1.731, 95%CI 1.367-2.193, P < 0.001). Radical prostatectomy (RP), androgen deprivation therapy including surgical castration and medical castration, iodine-125 seed brachytherapy (¹²⁵I limited), and chemotherapy were independent risk factors of MetS. The MetS incidence rates after treatment in ADT+¹²⁵I limited+chemotherapy compared to RP+TURP+EBRT were statistically significant at the corresponding risk grade (all P < 0.001). After treatment, the occurrence rates of progressive incidences were higher in MetS-PCa patients compared to non-MetS-PCa patients (all P < 0.001). So, the findings suggested that among PCa patients, multiple factors contribute to the occurrence of MetS, and PCa treatment is one among them. ADT+¹²⁵I limited+chemotherapy may be the most influential treatment for MetS.