Pre-diagnostic carbohydrate intake and treatment failure after radical prostatectomy for early-stage prostate cancer

Kyeezu Kim, Angela Kong, Robert C. Flanigan, Marcus L. Quek, Courtney M P Hollowell, Patricia Vidal, Jefferey Branch, Leslie A. Dean, Virgilia Macias, Andre A. Kajadacsy-Balla, Marian L. Fitzgibbon, Daisy Cintron, Li Liu, Vincent L. Freeman*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


Purpose: An association between dietary carbohydrate intake and prostate cancer (PCa) prognosis is biologically plausible, but data are scarce. This prospective cohort study examined the relation between pre-diagnostic carbohydrate intake and treatment failure following radical prostatectomy for clinically early-stage PCa. Methods: We identified 205 men awaiting radical prostatectomy and assessed their usual dietary intake of carbohydrates using the 110-item Block food frequency questionnaire. We also evaluated carbohydrate intake quality using a score based on the consumption of sugars relative to fiber, fat, and protein. Logistic regression analyzed their associations with the odds of treatment failure, defined as a detectable and rising serum prostate-specific antigen (PSA) or receiving androgen deprivation therapy (ADT) within 2 years. Results: Sucrose consumption was associated with a higher odds and fiber consumption with a lower odds of ADT after accounting for age, race/ethnicity, body mass index, and tumor characteristics (odds ratio [OR] (95% confidence interval [CI]) 5.68 (1.71, 18.9) for 3rd vs. 1st sucrose tertile and 0.88 (0.81, 0.96) per gram of fiber/day, respectively). Increasing carbohydrate intake quality also associated with a lower odds of ADT (OR (95% CI) 0.78 (0.66, 0.92) per unit increase in score, range 0–12). Conclusions: Pre-diagnostic dietary carbohydrate intake composition and quality influence the risk of primary treatment failure for early-stage PCa. Future studies incorporating molecular aspects of carbohydrate metabolism could clarify possible underlying mechanisms.

Original languageEnglish (US)
Pages (from-to)271-279
Number of pages9
JournalCancer Causes and Control
Issue number3
StatePublished - Mar 15 2019


  • Dietary carbohydrate
  • Insulin sensitivity
  • Prostate cancer prognosis
  • Treatment failure

ASJC Scopus subject areas

  • Oncology
  • Cancer Research


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