Stronger Association between Obesity and Biochemical Progression after Radical Prostatectomy among Men Treated in the Last 10 Years
Open Access
- 15 April 2005
- journal article
- Published by American Association for Cancer Research (AACR) in Clinical Cancer Research
- Vol. 11 (8), 2883-2888
- https://doi.org/10.1158/1078-0432.ccr-04-2257
Abstract
Background: Prior prospective cohort studies found that obesity was associated with increased risk of prostate cancer death. However, in the last 20 years dramatic changes in both the extent of obesity and prostate cancer screening and treatment have occurred. Whether the association between obesity and aggressive disease has changed as a result of these temporal changes is unclear. Methods: The study population consisted of 2,832 men treated by anatomic radical retropubic prostatectomy between 1985 and 2004 by a single surgeon. We evaluated the associations of obesity (body mass index ≥30 kg/m2)with tumor stage and grade using logistic regression and with biochemical progression using Cox proportional hazards regression. We examined whether these associations have changed over the last 20 years. Results: On multivariable analysis, the strength of the positive association between obesity and high-grade disease increased over time whereas the strength of the positive association between obesity and positive surgical margins decreased over time. The strength of the positive association between obesity and extraprostatic extension fluctuated over time, although the strongest and only statistically significant association was among men treated since 2000. The association between obesity and biochemical progression was strongest among men treated since 1995 (relative risk, 1.90; 95% confidence interval, 1.09-3.30; P = 0.02). Conclusions: In the current study, with the exception of positive surgical margins, the positive association between obesity and high-grade disease, advanced stage, and biochemical progression after radical retropubic prostatectomy was in general strongest among men treated in the last 10 years. The reasons for these findings are not clear, although factors possibly related to prostate-specific antigen–based screening and/or other temporal changes in prostate cancer diagnosis and treatment may play a role.Keywords
This publication has 35 references indexed in Scilit:
- The association of body mass index and prostate‐specific antigen in a population‐based studyCancer, 2005
- Diet, anthropometric measures and prostate cancer risk: a review of prospective cohort and intervention studiesBJU International, 2004
- The Long-Term Clinical Impact of Biochemical Recurrence of Prostate Cancer 5 or More Years After Radical ProstatectomyJournal of Urology, 2003
- Overweight, Obesity, and Mortality from Cancer in a Prospectively Studied Cohort of U.S. AdultsNew England Journal of Medicine, 2003
- Family history of prostate cancer and obesity in relation to high‐grade disease and extraprostatic extension in young men with prostate cancerThe Prostate, 2003
- Hormones and prostate cancer: Current perspectives and future directionsThe Prostate, 2002
- ERA SPECIFIC BIOCHEMICAL RECURRENCE-FREE SURVIVAL FOLLOWING RADICAL PROSTATECTOMY FOR CLINICALLY LOCALIZED PROSTATE CANCERJournal of Urology, 2001
- Combination of prostate-specific antigen, clinical stage, and Gleason score to predict pathological stage of localized prostate cancer. A multi-institutional updatePublished by American Medical Association (AMA) ,1997
- Prostate specific antigen in a community‐based sample of men without prostate cancer: Correlations with prostate volume, age, body mass index, and symptoms of prostatismThe Prostate, 1995
- Measurement of Prostate-Specific Antigen in Serum as a Screening Test for Prostate CancerNew England Journal of Medicine, 1991