Cartilage oligomeric matrix protein in patients with osteoarthritis is independently associated with metastatic disease in prostate cancer
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Samuel Rosas1,2, Ryan T. Hughes1, Michael Farris1, Hwajin Lee1, Emory R. McTyre3, Johannes F. Plate2, Lihong Shi4, Cynthia L. Emory2, A. William Blackstock1, Bethany A. Kerr2,4 and Jeffrey S. Willey1,2
1 Department of Radiation Oncology, Wake Forest School of Medicine, Winston-Salem, NC, USA
2 Department of Orthopaedic Surgery, Wake Forest School of Medicine, Winston-Salem, NC, USA
3 Radiation Oncology, Greenville Health System Cancer Institute, Greenville, SC, USA
4 Department of Cancer Biology, Wake Forest School of Medicine, Winston-Salem, NC, USA
|Jeffrey S. Willey,||email:||email@example.com|
Keywords: prostate cancer; osteoarthritis; distant metastasis; arthroplasty; joint surgery
Received: April 16, 2019 Accepted: June 29, 2019 Published: July 30, 2019
Metastatic prostate cancer has a 5-year survival rate of 30%. Identifying predictors of metastasis outcome could potentially reduce patient mortality. The objective of this study was to determine whether osteoarthritis had an impact on outcomes of prostate cancer including death, local recurrence and/or metastasis and to determine whether cartilage oligomeric matrix protein was involved. We performed a retrospective case-control study of patients with prostate cancer with and without the diagnosis of osteoarthritis and completed immunohistochemistry (IHC) analysis of prostate (n=20) and lymph node (n=7) surgical specimens. We evaluated death, local recurrence and metastatic disease by various IHC biomarkers including prostate specific membrane antigen (PSMA), cartilage oligomeric matrix protein (COMP), CD31, and Ki-67.
Our model identified osteoarthritis as an independent risk factor for metastatic disease (OR 5.24, 95% CI 1.49 - 18.41). Most notably, when joint arthroplasty was included in the model, osteoarthritis was no longer an independent risk factor for this outcome (p=0.071). IHC demonstrated that those with osteoarthritis, had greater expression of COMP in the prostate samples (mean 23.9% vs 5.84%, p<0.05) but not of Ki-67, CD31, or PSMA. This study identified and quantified increased metastatic disease in patients with osteoarthritis. Also, patients with osteoarthritis expressed increased COMP levels in the prostate and most likely in distant lymphatic nodes. Moreover, our findings suggest that joint arthroplasty may affect the ability of osteoarthritis to promote metastasis, which could impact treatment protocols and survival outcomes of the most common cause of cancer-related death (metastasis) in the United States.
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