BACKGROUND: Obesity is associated with an increased risk of biochemical recurrence (BCR) after radical prostatectomy (RP). It is unclear whether this is due to technical challenges related to operating on obese men or other biologic factors. OBJECTIVE: To examine whether obesity predicts higher prostate-specific antigen (PSA) nadir (as a measure of residual PSA-producing tissue) after RP and if this accounts for the greater BCR risk in obese men. DESIGN, SETTING, AND PARTICIPANTS: A retrospective analysis of 1038 RP patients from 2001 to 2010 in the multicenter US Veterans Administration-based Shared Equal Access Regional Cancer Hospital database with median follow-up of 41 mo. INTERVENTION: All patients underwent RP. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: We evaluated the relationship between body mass index (BMI) and ultrasensitive PSA nadir within 6 mo after RP. Adjusted proportional hazards models were used to examine the association between BMI and BCR with and without PSA nadir. RESULTS AND LIMITATIONS: Mean BMI was 28.5 kg/m2. Higher BMI was associated with higher PSA nadir on both univariable (p=0.001) and multivariable analyses (p<0.001). Increased BMI was associated with increased BCR risk (hazard ratio [HR]: 1.06; p=0.007). Adjusting for PSA nadir slightly attenuated, but did not eliminate, this association (HR: 1.04, p=0.043). When stratified by PSA nadir, obesity only significantly predicted BCR in men with an undetectable nadir (p=0.006). Unfortunately, other clinically relevant end points such as metastasis or mortality were not available. CONCLUSIONS: Obese men are more likely to have a higher PSA nadir, suggesting that either more advanced disease or technical issues confound an ideal operation. However, even after adjusting for the increased PSA nadir, obesity remained predictive of BCR, suggesting that tumors in obese men are growing faster. This provides further support for the idea that obesity is biologically associated with prostate cancer progression. Published by Elsevier B.V.
BACKGROUND:Obesity is associated with an increased risk of biochemical recurrence (BCR) after radical prostatectomy (RP). It is unclear whether this is due to technical challenges related to operating on obesemen or other biologic factors. OBJECTIVE: To examine whether obesity predicts higher prostate-specific antigen (PSA) nadir (as a measure of residual PSA-producing tissue) after RP and if this accounts for the greater BCR risk in obesemen. DESIGN, SETTING, AND PARTICIPANTS: A retrospective analysis of 1038 RP patients from 2001 to 2010 in the multicenter US Veterans Administration-based Shared Equal Access Regional Cancer Hospital database with median follow-up of 41 mo. INTERVENTION: All patients underwent RP. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: We evaluated the relationship between body mass index (BMI) and ultrasensitive PSAnadir within 6 mo after RP. Adjusted proportional hazards models were used to examine the association between BMI and BCR with and without PSAnadir. RESULTS AND LIMITATIONS: Mean BMI was 28.5 kg/m2. Higher BMI was associated with higher PSAnadir on both univariable (p=0.001) and multivariable analyses (p<0.001). Increased BMI was associated with increased BCR risk (hazard ratio [HR]: 1.06; p=0.007). Adjusting for PSAnadir slightly attenuated, but did not eliminate, this association (HR: 1.04, p=0.043). When stratified by PSAnadir, obesity only significantly predicted BCR in men with an undetectable nadir (p=0.006). Unfortunately, other clinically relevant end points such as metastasis or mortality were not available. CONCLUSIONS:Obesemen are more likely to have a higher PSAnadir, suggesting that either more advanced disease or technical issues confound an ideal operation. However, even after adjusting for the increased PSAnadir, obesity remained predictive of BCR, suggesting that tumors in obesemen are growing faster. This provides further support for the idea that obesity is biologically associated with prostate cancer progression. Published by Elsevier B.V.
Authors: Daniel M Moreira; Joseph C Presti; William J Aronson; Martha K Terris; Christopher J Kane; Christopher L Amling; Stephen J Freedland Journal: J Urol Date: 2009-09-16 Impact factor: 7.450
Authors: Michael L Eisenberg; Benjamin J Davies; Matthew R Cooperberg; Janet E Cowan; Peter R Carroll Journal: Eur Urol Date: 2009-04-03 Impact factor: 20.096
Authors: Daniel M Moreira; Joseph C Presti; William J Aronson; Martha K Terris; Christopher J Kane; Christopher L Amling; Stephen J Freedland Journal: BJU Int Date: 2009-11-12 Impact factor: 5.588
Authors: Jonas Busch; Mark L Gonzalgo; Natalia Leva; Michelle Ferrari; Hannes Cash; Carsten Kempkensteffen; Stefan Hinz; Kurt Miller; Ahmed Magheli Journal: World J Urol Date: 2014-05-23 Impact factor: 4.226
Authors: Crystal S Denlinger; Jennifer A Ligibel; Madhuri Are; K Scott Baker; Wendy Demark-Wahnefried; Don Dizon; Debra L Friedman; Mindy Goldman; Lee Jones; Allison King; Grace H Ku; Elizabeth Kvale; Terry S Langbaum; Kristin Leonardi-Warren; Mary S McCabe; Michelle Melisko; Jose G Montoya; Kathi Mooney; Mary Ann Morgan; Javid J Moslehi; Tracey O'Connor; Linda Overholser; Electra D Paskett; Jeffrey Peppercorn; Muhammad Raza; M Alma Rodriguez; Karen L Syrjala; Susan G Urba; Mark T Wakabayashi; Phyllis Zee; Nicole R McMillian; Deborah A Freedman-Cass Journal: J Natl Compr Canc Netw Date: 2014-10 Impact factor: 11.908
Authors: June M Chan; Stacey A Kenfield; Rebecca E Graff; Crystal S Langlais; Erin L Van Blarigan; Claire H Pernar; Meir J Stampfer; Edward L Giovannucci; Lorelei A Mucci Journal: Br J Cancer Date: 2022-08-26 Impact factor: 9.075
Authors: James P Dean; Cynthia C Sprenger; Junxiang Wan; Kathleen Haugk; William J Ellis; Daniel W Lin; John M Corman; Bruce L Dalkin; Elahe Mostaghel; Peter S Nelson; Pinchas Cohen; Bruce Montgomery; Stephen R Plymate Journal: J Clin Endocrinol Metab Date: 2013-03-26 Impact factor: 5.958
Authors: Ross J Mason; Stephen A Boorjian; Bimal Bhindi; Laureano Rangel; Igor Frank; R Jeffrey Karnes; Matthew K Tollefson Journal: Can Urol Assoc J Date: 2018-03-19 Impact factor: 1.862
Authors: Jill M Hamilton-Reeves; Chelsea N Johnson; Lauren K Hand; Misty D Bechtel; Hilary L Robertson; Carrie Michel; Meredith Metcalf; Prabhakar Chalise; Nicholas J Mahan; Moben Mirza; Eugene K Lee; Debra K Sullivan; Jennifer R Klemp; Christie A Befort; William P Parker; Heather D Gibbs; Wendy Demark-Wahnefried; J Brantley Thrasher Journal: Nutr Cancer Date: 2020-12-09 Impact factor: 2.900