# Evaluation of Mortality Risk Factors in Prostate Cancer: Impact of Demographic, Clinical, Laboratory, Therapeutic, and Trace Element Influences

## TL;DR

This study identifies factors like age, PSA levels, hemoglobin, metastases, and trace elements that predict mortality in prostate cancer patients in the DRC.

## Contribution

The study is among the first to evaluate trace elements as mortality predictors in prostate cancer patients in the Democratic Republic of the Congo.

## Key findings

- Age, PSA, hemoglobin, and metastases were significant predictors of mortality in prostate cancer patients.
- Elevated urinary strontium, manganese, and cobalt levels were linked to increased mortality risk.
- Higher tissue copper levels were associated with reduced mortality risk.

## Abstract

Prostate cancer (PCa) is a significant contributor to male mortality globally, including in the Democratic Republic of the Congo (DRC). Various factors play a role in its onset and progression. The impact of trace elements and other risk factors on the survival of PCa patients is not extensively studied in this setting. This study aimed to evaluate the effect of demographic characteristics, clinical factors, laboratory investigations, therapeutic aspects, and trace elements on the occurrence of mortality in this disease.

A sample of 94 PCa patients was included in this study. Among them, 22 (23.40%) deceased, while 72 (76.60%) survived during a 5‐year follow‐up period. Sociodemographic, clinical, laboratory investigations, therapeutic aspects, and trace element levels (in tissues and urine) were gathered and analyzed. Statistical analyses were conducted to pinpoint mortality predictors, with Cox regression utilized to account for variable impacts.

In multivariate analyses, age (adjusted hazard ratio [aHR] = 1.06; p = 0.025), prostate‐specific antigen [PSA] (aHR = 1.01; p = 0.037), hemoglobin (aHR = 0.69; p = 0.010), and the presence of metastases (aHR = 3.83; p = 0.037) were identified as significant predictors of mortality. Furthermore, elevated levels of urinary strontium (aHR = 1.08; p = 0.016), manganese (aHR = 1.51; p = 0.003), and cobalt (aHR = 1.30; p = 0.030) were linked to an increased risk of mortality. Conversely, higher levels of tissue copper were associated with a reduced risk of death (aHR = 0.99; p = 0.045).

The results obtained have indicated that specific trace elements, along with age, PSA level, hemoglobin level, and the presence of metastases, are predictive of mortality in PCa patients in the DRC. Enhanced comprehension and control of these factors may lead to improved survival outcomes. Additional investigation is warranted to validate these correlations and to facilitate the development of therapeutic interventions.