Significance of Preoperative HbA1c Level in Patients With Diabetes Mellitus and Clinically Localized Prostate Cancer

INTRODUCTION. We investigated potential relationships of history of diabetes mellitus (DM) and glycemic control, represented by hemoglobin A1c (HbA1c) level, with characteristics of tumor among patients who received radical prostatectomy (RP) for clinically localized prostate cancer. METHODS. We reviewed data of 740 patients who underwent RP for clinically localized prostate cancer between 2004 and 2008 without receiving preoperative radiation or hormonal treatment. Univariate and multivariate logistic regression analyses addressed the associations of history of DM and HbA1c level with known prognostic variables of prostate cancer. RESULTS. No significant differences were observed in various preoperative and pathological parameters between those with (n = 89) and without DM (n = 651). When only the subjects with DM were divided into two groups (group 1 and 2) according to HbA1c level (< 6.5% vs. >= 6.5%), group 2 demonstrated significantly higher rate of extraprostatic extension of tumor (P = 0.043) and high (>= 7) pathological Gleason score (P = 0.005) than group 1. Also among those with DM, HbA1c level was observed to be an independent predictor for high pathologic Gleason score (P = 0.010) and extraprostatic extension of tumor (P = 0.035), respectively in multivariate analyses. CONCLUSION. Although simple history of having DM may not be a significant factor regarding aggressiveness of clinically localized prostate cancer, the glycemic control, as represented by HbA1c level, maybe a useful preoperative predictor of aggressive tumor profile among patients with DM who are also diagnosed with clinically localized prostate cancer. Prostate 69: 820-826, 2009. (c) 2009 Wiley-Liss, Inc.