Radical prostatectomy neutralizes obesity-driven risk of prostate cancer progression
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Radical prostatectomy neutralizes obesity-driven risk of prostate cancer progression. / Schiffmann, Jonas; Salomon, Georg; Tilki, Derya; Budäus, Lars; Karakiewicz, Pierre I; Leyh-Bannurah, Sami-Ramzi; Pompe, Raisa S; Haese, Alexander; Heinzer, Hans; Huland, Hartwig; Graefen, Markus; Tennstedt, Pierre.
In: UROL ONCOL-SEMIN ORI, Vol. 35, No. 5, 05.2017, p. 243-249.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Radical prostatectomy neutralizes obesity-driven risk of prostate cancer progression
AU - Schiffmann, Jonas
AU - Salomon, Georg
AU - Tilki, Derya
AU - Budäus, Lars
AU - Karakiewicz, Pierre I
AU - Leyh-Bannurah, Sami-Ramzi
AU - Pompe, Raisa S
AU - Haese, Alexander
AU - Heinzer, Hans
AU - Huland, Hartwig
AU - Graefen, Markus
AU - Tennstedt, Pierre
N1 - Copyright © 2017 Elsevier Inc. All rights reserved.
PY - 2017/5
Y1 - 2017/5
N2 - INTRODUCTION: Obesity negatively affects several prostate cancer (PCa) outcomes, including mortality to PCa. However, the validity of several such associations is still under debate, including its effect on pathological stage at radical prostatectomy (RP) and subsequent biochemical recurrence (BCR), which represents the focus of this study.METHODS: We relied on patients with PCa treated with RP at the Martini-Klinik Prostate Cancer Center between 2004 and 2015. First, multivariable logistic regression analyses tested for association between obesity and non-organ-confined disease (≥pT3 or pN1). Second, multivariable Cox regression analyses examined obesity effect on BCR. Last, in a propensity score-matched cohort, Kaplan-Meier analyses assessed BCR-free survival according to body mass index (kg/m2) (BMI) strata (≥30 vs.<25).RESULTS: Of 16,014 individuals, 2,403 (15%) men were obese (BMI≥30). Median follow-up was 36.4 months (interquartile range: 13.3-60.8). Obese patients were more likely to harbor non-organ-confined disease at final pathology (odds ratio = 1.27; 95% CI: 1.13-1.43; P<0.001) but did not have higher BCR rates (hazard ratio = 0.98; 95% CI: 0.86-1.11; P = 0.7). Similarly, BCR-free survival was not different between obese and nonobese men, after propensity score matching (log rank P = 0.9).CONCLUSION: Obesity (BMI ≥30) might predispose to higher rates of non-organ-confined disease at RP. However, obesity was not an independent predictor of BCR after surgery. Consequently, the unfavorable effect of obesity on PCa might be limited to local spread of the disease and might be neutralized after RP.
AB - INTRODUCTION: Obesity negatively affects several prostate cancer (PCa) outcomes, including mortality to PCa. However, the validity of several such associations is still under debate, including its effect on pathological stage at radical prostatectomy (RP) and subsequent biochemical recurrence (BCR), which represents the focus of this study.METHODS: We relied on patients with PCa treated with RP at the Martini-Klinik Prostate Cancer Center between 2004 and 2015. First, multivariable logistic regression analyses tested for association between obesity and non-organ-confined disease (≥pT3 or pN1). Second, multivariable Cox regression analyses examined obesity effect on BCR. Last, in a propensity score-matched cohort, Kaplan-Meier analyses assessed BCR-free survival according to body mass index (kg/m2) (BMI) strata (≥30 vs.<25).RESULTS: Of 16,014 individuals, 2,403 (15%) men were obese (BMI≥30). Median follow-up was 36.4 months (interquartile range: 13.3-60.8). Obese patients were more likely to harbor non-organ-confined disease at final pathology (odds ratio = 1.27; 95% CI: 1.13-1.43; P<0.001) but did not have higher BCR rates (hazard ratio = 0.98; 95% CI: 0.86-1.11; P = 0.7). Similarly, BCR-free survival was not different between obese and nonobese men, after propensity score matching (log rank P = 0.9).CONCLUSION: Obesity (BMI ≥30) might predispose to higher rates of non-organ-confined disease at RP. However, obesity was not an independent predictor of BCR after surgery. Consequently, the unfavorable effect of obesity on PCa might be limited to local spread of the disease and might be neutralized after RP.
KW - Aged
KW - Disease Progression
KW - Disease-Free Survival
KW - Humans
KW - Lymphatic Metastasis
KW - Male
KW - Middle Aged
KW - Neoplasm Grading
KW - Neoplasm Invasiveness
KW - Neoplasm Recurrence, Local
KW - Neoplasm Staging
KW - Neoplasm, Residual
KW - Obesity
KW - Prostate-Specific Antigen
KW - Prostatectomy
KW - Prostatic Neoplasms
KW - Journal Article
U2 - 10.1016/j.urolonc.2016.12.014
DO - 10.1016/j.urolonc.2016.12.014
M3 - SCORING: Journal article
C2 - 28161322
VL - 35
SP - 243
EP - 249
JO - UROL ONCOL-SEMIN ORI
JF - UROL ONCOL-SEMIN ORI
SN - 1078-1439
IS - 5
ER -