Table 3. Association of the telomere biomarker* with risk of biochemical recurrence, lethal prostate cancer, prostate cancer death, and non-prostate cancer death, Health Professionals Follow-up Study.
| Outcome | Events/Person-years | Age and year of diagnosis adjusted | Multivariable adjusted‡ | ||||
|---|---|---|---|---|---|---|---|
|
| |||||||
| HR | (95% CI) | P | HR | (95% CI) | P | ||
| Biochemical recurrence† | |||||||
| Less variable/Longer | 22/1,083 | 1.00 | (reference) | -- | 1.00 | (reference) | -- |
| More variable/Longer | 35/841 | 1.96 | (1.15-3.34) | 0.014 | 1.42 | (0.82-2.45) | 0.21 |
| Less variable/Shorter | 74/3,149 | 1.12 | (0.69-1.80) | 0.66 | 1.02 | (0.63-1.66) | 0.93 |
| More variable/Shorter | 40/880 | 2.12 | (1.26-3.57) | 0.005 | 1.67 | (0.98-2.83) | 0.06 |
| Lethal prostate cancer†,§ | |||||||
| Less variable/Longer | 2/1,304 | 1.00 | (reference) | -- | 1.00 | (reference) | -- |
| More variable/Longer | 8/1,137 | 4.49 | (0.95-21.16) | 0.06 | 2.48 | (0.52-11.93) | 0.26 |
| Less variable/Shorter | 24/3,733 | 3.93 | (0.93-16.66) | 0.06 | 3.74 | (0.88-15.96) | 0.07 |
| More variable/Shorter | 20/1,148 | 12.31 | (2.87-52.75) | 0.0007 | 8.12 | (1.88-34.97) | 0.005 |
| Prostate cancer death§ | |||||||
| Less variable/Longer | 1/1,312 | 1.00 | (reference) | -- | 1.00 | (reference) | -- |
| More variable/Longer | 6/1,163 | 6.68 | (0.80-55.55) | 0.08 | 3.76 | (0.44-31.79) | 0.22 |
| Less variable/Shorter | 19/3,822 | 6.21 | (0.83-46.46) | 0.08 | 6.23 | (0.82-47.06) | 0.08 |
| More variable/Shorter | 20/1,194 | 24.59 | (3.29-183.62) | 0.002 | 14.10 | (1.87-106.49) | 0.01 |
| Non-prostate cancer death | |||||||
| Less variable/Longer | 28/1,312 | 1.00 | (reference) | -- | 1.00 | (reference) | -- |
| More variable/Longer | 30/1,163 | 1.29 | (0.77-2.17) | 0.33 | 1.21 | (0.71-2.07) | 0.48 |
| Less variable/Shorter | 65/3,822 | 0.81 | (0.52-1.26) | 0.35 | 0.78 | (0.50-1.23) | 0.28 |
| More variable/Shorter | 21/1,194 | 0.92 | (0.52-1.62) | 0.76 | 0.88 | (0.49-1.57) | 0.66 |
The combination of variability in telomere length among prostate cancer cells and telomere length in prostate cancer-associated stromal cells.
Restricted to men without metastatic prostate cancer at the time of diagnosis.
Adjusted for age (continuous) and year (continuous) of diagnosis, prostatectomy Gleason sum (categorical: ≤6, 3+4, 4+3, ≥8), pathologic TNM stage (categorical ≥T3b) and serum PSA concentration at diagnosis (categorical: <10, 10-20, >20 ng/mL, unknown).
Using the group with the largest sample size – less variable/shorter – as the reference, the HRs are as follows: lethal prostate cancer – less variable/longer 0.27 (P=0.07), less variable/shorter 0.66 (P=0.33), more variable/shorter 2.17 (P=0.02); death from prostate cancer - less variable/longer 0.16 (P=0.08), less variable/shorter 0.61 (P=0.30), more variable/shorter 2.26 (P=0.02).