Diet quality and Gleason grade progression among localised prostate cancer patients on active surveillance

• Published in: British journal of cancer Vol. 120; no. 4; pp. 466 - 471
• Main Authors: Gregg, Justin R., Zheng, Jiali, Lopez, David S., Reichard, Chad, Browman, Gladys, Chapin, Brian, Kim, Jeri, Davis, John, Daniel, Carrie R.
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 19-02-2019; Nature Publishing Group
• Subjects: 631/67/2324; 631/67/589/466; 692/308/174; Aged; Biomedical and Life Sciences; Biomedicine; Cancer Research; Diet; Drug Resistance; Epidemiology; Humans; Inflammation; Male; Middle Aged; Molecular Medicine; Neoplasm Grading; Oncology; Proportional Hazards Models; Prospective Studies; Prostate cancer; Prostatic Neoplasms - mortality; Prostatic Neoplasms - pathology; Quality; Statistical models; Surveillance; Tumors
• ISSN: 0007-0920; 1532-1827
• DOI: 10.1038/s41416-019-0380-2

Background
High diet quality may support a metabolic and anti-inflammatory state less conducive to tumour progression. We prospectively investigated diet quality in relation to Gleason grade progression among localised prostate cancer patients on active surveillance, a clinical management strategy of disease monitoring and delayed intervention.
Methods
Men with newly diagnosed Gleason score 6 or 7 prostate cancer enroled on a biennial monitoring regimen. Patients completed a food frequency questionnaire (FFQ) at baseline (
n
 = 411) and first 6-month follow-up (
n
 = 263). Cox proportional hazards models were fitted to evaluate multivariable-adjusted associations of diet quality [defined via the Healthy Eating Index (HEI)-2015] with Gleason grade progression.
Results
After a median follow-up of 36 months, 76 men progressed. Following adjustment for clinicopathologic factors, we observed a suggestive inverse association between baseline diet quality and Gleason grade progression [hazard ratio (HR) and 95% confidence interval (CI) for the highest vs. the lowest HEI-2015 tertile: 0.59 (0.32–1.08);
P
trend
 = 0.06]. We observed no associations with diet quality at 6-month follow-up, nor change in diet quality from baseline.
Conclusions
In localised prostate cancer patients on surveillance, higher diet quality or conformance with United States dietary guidelines at enrolment may lower risk of Gleason grade progression, though additional confirmatory research is needed.