Adult urologyRelationship between obesity and race in predicting adverse pathologic variables in patients undergoing radical prostatectomy1☆,
Section snippets
Material and methods
The Center for Prostate Disease Research Triservice Multicenter Longitudinal Prostate Cancer Database was queried to identify patients undergoing RP at three military medical centers: Naval Medical Center, San Diego, California; Madigan Army Medical Center, Tacoma, Washington; and Wilford Hall Medical Center, San Antonio, Texas. At these institutions, a total of 860 patients undergoing RP between 1993 and 1998 were identified. The Center for Prostate Disease Research Database uses standardized
Results
Of 860 patients, 171 (20%) were categorized as obese, 425 (49%) as overweight, and 264 (31%) as normal according to the BMI determination. Table I shows the sample sizes, mean (with standard deviation), percentage, and test outcome (P values) for comparison of the three BMI categories on the basis of the demographic and pathologic variables. The age at presentation for RP was significantly lower in patients with higher degrees of obesity (P = 0.001). As the BMI increased, the percentage of
Comment
Numerous studies have suggested an association between dietary fat intake and prostate cancer risk, and some have proposed that dietary fat may promote the development of more lethal cancers.3, 4, 5, 6, 7, 8, 9, 10 Because obesity may be an end result of higher fat diets, we hypothesized that obesity may be associated with the earlier development of advanced disease in patients undergoing RP. Our results show that obese patients present for RP at a younger age, with higher grade and more
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Body mass index was associated with upstaging and upgrading in patients with low-risk prostate cancer who met the inclusion criteria for active surveillance
2015, Urologic Oncology: Seminars and Original InvestigationsObesity and long-term survival after radical prostatectomy
2014, Journal of UrologyCitation Excerpt :In this report we found that BMI is a significant independent predictor of BRFS (mild HR 1.30, p = 0.002; moderate/severe HR 1.45, p = 0.028) and OS (mild HR 1.41, p = 0.003; moderate/severe HR 1.81, p = 0.033), but only mild obesity predicted PCSS (HR 1.51, p = 0.040) whereas moderate/severe obesity did not (HR 1.58, p = 0.356). Obesity is associated with higher grade and stage disease at diagnosis9,10 as well as after treatment with radical prostatectomy.14–16 To date, most reports of a higher BMI-worse BRFS association after RP have fewer than 5 years of followup.17–20
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Research supported by the Center for Prostate Disease Research, a Department of Defense program of the Uniformed Services University of the Health Sciences funded by the U.S. Army Medical Research and Materiel Command.
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The opinions and assertions contained herein are the views of the authors and are not to be construed as reflecting the views of the U.S. Navy, Army, Air Force, or Department of Defense.