1328 THE INFLUENCE OF INCREASED BMI AS RISK FACTOR OF LOCALIZED PROSTATE CANCER IN PATIENTS UNDERGOING RADICAL PROSTATECTOMY

You have accessJournal of UrologyProstate Cancer: Localized VI1 Apr 20121328 THE INFLUENCE OF INCREASED BMI AS RISK FACTOR OF LOCALIZED PROSTATE CANCER IN PATIENTS UNDERGOING RADICAL PROSTATECTOMY Maximilien Goris Gbenou, Alexandre Peltier, Jean-Gabriel Lopez, and Roland Van Maximilien Goris GbenouMaximilien Goris Gbenou Valence, France More articles by this author , Alexandre PeltierAlexandre Peltier Brussels, Belgium More articles by this author , Jean-Gabriel LopezJean-Gabriel Lopez Valence, France More articles by this author , and Roland VanRoland Van Brussels, Belgium More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.1710AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Recent studies have shown that the higher BMI was associated with a greater percentage of the prostate involved with cancer, increased tumor volume, high-grade disease, enlarged prostates, increased risk of positive margins and PSA with high risk of postoperative recurrence. The purpose of the present study was to assess the impact of obesity in patients with localized prostate cancer undergoing radical prostatectomy. METHODS Between March 1999 and October 2006, 443 patients with localized prostate cancer underwent radical prostatectomy (RP) at the Jules Bordet Institute. We retrospectively reviewed preoperative body mass index (BMI) and whole prostate weight in this cohort of patients. We used multivariable regression modelling adjusting for age, year of surgery, preoperative serum prostate-specific antigen (PSA), pathological stage and Gleason grade. RESULTS Patient data were as follows: Median age, 62.4 years (45-74); mean PSA, 12 ng/mL (0.5-22.6); 73.6% of patients had non-palpable disease (T1c); median biopsy Gleason score 6 (3-9); mean RP specimen weight, 54 g (SD 20); median pathological Gleason score, 7 (4-10); 68.64% of patients had organ-confined (pT2) disease. The mean Body Mass Index (BMI) was 26,50 Kg/m (SD=4,82): <25 (170 patients). The distribution of patients according to their BMI was as follows: BMI<25, 170 patients, BMI=25-30: 224, BMI>30: 69. According to this 3 BMI groups, the mean prostate weight was respectively 47g (+/−13,7), 47g (+/−15) and 59g (+/−26) (p<0.00184). There was no significant difference in the average initial PSA, the rate of upgrading prostate cancer and the average age. Compared with patients with BMI<25 kg/m (2), men with BMI>30 kg/m (2) had a increased prostate weight: 47g+/−13 versus 59g+/−25 (p <0.00015). Of the entire cohort, 227 patients (48,29%) had upgrading Gleason sum. The mean biopsy Gleason score of biopsy and specimens was respectively 7 and 9 (p<0.00000). In multivariable regression, preoperative BMI was positively associated with a increased prostate weight (p=0.000000), the higher initial PSA (0.00000), the higher biopsy Gleason score (p=0.019833), the higher final Gleason score (p=0.00000) and with the risk of upgrading prostate cancer (0.00000). CONCLUSIONS These data support the hypothesis that obesity is associated with high prostate weight, increasing risk of upgrading prostate cancer and higher initial PSA. This study provides further evidence that obese men undergoing radical prostatectomy have more aggressive prostate cancers. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e538 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Maximilien Goris Gbenou Valence, France More articles by this author Alexandre Peltier Brussels, Belgium More articles by this author Jean-Gabriel Lopez Valence, France More articles by this author Roland Van Brussels, Belgium More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...