Year: 2017
Type: article
Study design: Observational Study
Abstract: You have accessJournal of UrologyProstate Cancer: Localized: Surgical Therapy VII1 Apr 2017MP93-16 IMPACT OF OBESITY ON PROSTATE CANCER RECURRENCE AFTER RADICAL PROSTATECTOMY Vidit Sharma, Mary E Westerman, Michele Colicchia, Alessandro Morlacco, Matthew K. Tollefson, Stephen A Boorjian, R. Houston Thompson, Igor Frank, Matthew T Gettman, and R. Jeffrey Karnes Vidit SharmaVidit Sharma More articles by this author , Mary E WestermanMary E Westerman More articles by this author , Michele ColicchiaMichele Colicchia More articles by this author , Alessandro MorlaccoAlessandro Morlacco More articles by this author , Matthew K. TollefsonMatthew K. Tollefson More articles by this author , Stephen A BoorjianStephen A Boorjian More articles by this author , R. Houston ThompsonR. Houston Thompson More articles by this author , Igor FrankIgor Frank More articles by this author , Matthew T GettmanMatthew T Gettman More articles by this author , and R. Jeffrey KarnesR. Jeffrey Karnes More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.2898AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Conflicting data exist on the association of obesity with the risk of prostate cancer (PCa) recurrence after radical prostatectomy (RP), due in part to underpowered cohorts and limited follow up. Herein, we evaluated the association between obesity and PCa recurrence after RP using a large institutional dataset with long-term follow-up. METHODS We reviewed years 1987-2013 of the Mayo Clinic RP Registry to identify men with Body Mass Index (BMI) information available. Men who underwent PCa treatment prior to RP and men with metastatic disease at RP were excluded. Patients were grouped into four BMI categories: < 25, 25-29.9, 30-34.9, and > 35. BMI > 30 was defined as obese. Standard descriptive statistics compared baseline characteristics, while forced entry multivariable cox proportional hazard models assessed the association of BMI with metastasis and prostate cancer mortality (PCM). Multivariable models were adjusted for pre-RP PSA, pathologic Gleason Score, pT stage, pN stage, margin status, age, adjuvant hormone therapy, adjuvant radiation, year of surgery, and open vs robotic approach. RESULTS In our cohort of 18,039 men (median follow-up 9.3 years after RP), 20.6% (3,707), 51.9% (9,348), 21.9% (3,936) and 5.6% (1,016) had a BMI < 25, 25-29.9, 30-34.9, and > 35, respectively. Higher BMI categories had higher rates of pathologic Gleason Score 7-10 disease: 38.7%, 40.7%, 46.1%, 54.0%, respectively (p<0.001). Obese patients also had higher positive margin rates: 23.4%, 26.3%, 30.1%, 31.9%, respectively (p<0.001). PSA, pT stage, pN stage, and adjuvant therapy did not significantly differ between BMI categories (p>0.05). Log Rank comparisons found higher Kaplan-Meier rates of metastasis and PCM for patients with a BMI of 30-34.9 and > 35 (p<0.05 for all). On multivariable cox regression for metastasis, patients with a BMI 30-34.9 (HR 1.307, 95% CI 1.073-1.592, p=0.008) and BMI > 35 (HR 1.421, 95% CI 1.071-1.886, p=0.015) had an increased risk of metastasis relative to patients with a BMI < 25. Similarly, patients with a BMI 30-34.9 (HR 1.323, 95% 1.010-1.733, p=0.042) and BMI > 35 (HR 1.620, 95% CI 1.098-2.392, p=0.015) had higher PCM rates relative to patients with BMI < 25 on multivariable analysis. CONCLUSIONS Our data supports an independent association between BMI and PCa metastasis and cancer-specific mortality after RP. There was a direct increase in the odds of metastasis and PCM between the BMI 30-34.9 and BMI > 35 groups, further strengthening this link. Further study is warranted to determine if weight loss can abrogate this effect of obesity on PCa recurrence after RP. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e1242-e1243 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Vidit Sharma More articles by this author Mary E Westerman More articles by this author Michele Colicchia More articles by this author Alessandro Morlacco More articles by this author Matthew K. Tollefson More articles by this author Stephen A Boorjian More articles by this author R. Houston Thompson More articles by this author Igor Frank More articles by this author Matthew T Gettman More articles by this author R. Jeffrey Karnes More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...
Source: The Journal of Urology
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W2605116309