Table 4.

HR of lethal prostate cancer and prostate cancer death for the telomere biomarkera and the currently used prognostic characteristics, HPFS

OutcomeHRc(95% CI)P
Lethal prostate cancerb
 Telomere biomarker
  Less variable/longer1.00(Ref.)
  More variable/longer2.48(0.52–11.93)0.26
  Less variable/shorter3.74(0.88–15.96)0.07
  More variable/shorter8.12(1.88–34.97)0.005
 Prostatectomy Gleason sum
  ≤60.27(0.03–2.17)0.22
  3 + 41.00(Ref.)
  4 + 33.77(1.59–8.96)0.003
  ≥83.86(1.57–9.49)0.003
 Pathologic stage ≥T3b4.20(2.27–7.75)<0.0001
 Serum PSA concentration at diagnosis, ng/mL
  <101.00(Ref.)
  10—201.13(0.52–2.45)0.76
  >201.12(0.48–2.58)0.80
  Unknown1.55(0.68–3.55)0.30
Prostate cancer death
 Telomere biomarker
  Less variable/longer1.00(Ref.)
  More variable/longer3.76(0.44–31.79)0.22
  Less variable/shorter6.23(0.82–47.06)0.08
  More variable/shorter14.10(1.87–106.49)0.01
 Prostatectomy Gleason sum
  ≤6d0.000.99
  3+41.00(Ref.)
  4+32.93(1.04–8.25)0.04
  ≥84.45(1.6–12.44)0.004
 Pathologic stage ≥T3b5.08(2.63–9.84)<0.0001
 Serum PSA concentration at diagnosis, ng/mL
  <101.00(Ref.)
  10–200.71(0.26–1.94)0.50
  >201.19(0.47–3)0.71
  Unknown2.83(1.21–6.63)0.02
  • aThe combination of variability in telomere length among cancer cells and telomere length in CAS cells.

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

  • cMutually adjusted and adjusted for age (continuous) and year (continuous) of diagnosis.

  • dNo prostate cancer deaths occurred in these men. Combining ≤6 and 3 + 4 as the reference, the HRs of prostate cancer death were 4.54 (95% CI, 1.60–12.91; P = 0.004) for 4 + 3, and 6.84 (95% CI, 2.42–19.34; P = 0.0003) for ≥8. The HRs of prostate cancer death were unchanged for the telomere biomarker [less variable/longer: HR, 1.00 (reference group); more variable/longer: HR, 3.80 (95% CI, 0.45–32.13; P = 0.22); less variable/shorter: HR, 6.19 (95% CI, 0.82–46.74; P = 0.08); more variable/shorter: HR, 14.21 (95% CI, 1.88–107.28; P = 0.01)].