Table 3.

Association of the telomere biomarkera with risk of biochemical recurrence, lethal prostate cancer, prostate cancer death, and non–prostate cancer death, HPFS

Age and year of diagnosis adjustedMultivariable adjustedc
OutcomeEvents/person-yearsHR (95% CI)PHR (95% CI)P
Biochemical recurrenceb
 Less variable/longer22/1,0831.00 (Ref.)1.00 (Ref.)
 More variable/longer35/8411.96 (1.15–3.34)0.0141.42 (0.82–2.45)0.21
 Less variable/shorter74/3,1491.12 (0.69–1.80)0.661.02 (0.63–1.66)0.93
 More variable/shorter40/8802.12 (1.26–3.57)0.0051.67 (0.98–2.83)0.06
Lethal prostate cancerb,d
 Less variable/longer2/1,3041.00 (Ref.)1.00 (Ref.)
 More variable/longer8/1,1374.49 (0.95–21.16)0.062.48 (0.52–11.93)0.26
 Less variable/shorter24/3,7333.93 (0.93–16.66)0.063.74 (0.88–15.96)0.07
 More variable/shorter20/1,14812.31 (2.87–52.75)0.00078.12 (1.88–34.97)0.005
Prostate cancer deathd
 Less variable/longer1/1,3121.00 (Ref.)1.00 (Ref.)
 More variable/longer6/1,1636.68 (0.80–55.55)0.083.76 (0.44–31.79)0.22
 Less variable/shorter19/3,8226.21 (0.83–46.46)0.086.23 (0.82–47.06)0.08
 More variable/shorter20/1,19424.59 (3.29–183.62)0.00214.10 (1.87–106.49)0.01
Non–prostate cancer death
 Less variable/longer28/1,3121.00 (Ref.)1.00 (Ref.)
 More variable/longer30/1,1631.29 (0.77–2.17)0.331.21 (0.71–2.07)0.48
 Less variable/shorter65/3,8220.81 (0.52–1.26)0.350.78 (0.50–1.23)0.28
 More variable/shorter21/1,1940.92 (0.52–1.62)0.760.88 (0.49–1.57)0.66
  • aThe combination of variability in telomere length among prostate cancer cells and telomere length in prostate CAS cells.

  • bRestricted to men without metastatic prostate cancer at the time of diagnosis.

  • cAdjusted 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).

  • dUsing 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).