MP34-11 OBESITY, RISK OF BIOCHEMICAL RECURRENCE, AND PSADT AFTER RADICAL PROSTATECTOMY: RESULTS FROM THE SEARCH DATABASE

You have accessJournal of UrologyProstate Cancer: Epidemiology & Natural History II1 Apr 2018MP34-11 OBESITY, RISK OF BIOCHEMICAL RECURRENCE, AND PSADT AFTER RADICAL PROSTATECTOMY: RESULTS FROM THE SEARCH DATABASE Brandee Branche, Lauren Howard, Robert Hamilton, William Aronson, Martha Terris, Matthew Cooperberg, Christopher Amling, Christopher Kane, and Stephen Freedland Brandee BrancheBrandee Branche More articles by this author , Lauren HowardLauren Howard More articles by this author , Robert HamiltonRobert Hamilton More articles by this author , William AronsonWilliam Aronson More articles by this author , Martha TerrisMartha Terris More articles by this author , Matthew CooperbergMatthew Cooperberg More articles by this author , Christopher AmlingChristopher Amling More articles by this author , Christopher KaneChristopher Kane More articles by this author , and Stephen FreedlandStephen Freedland More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.1103AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES We previously showed that obesity is associated with increased risk of biochemical recurrence. More recently, we showed obesity is more strongly linked with increased risk of prostate cancer-specific mortality (PCSM) after radical prostatectomy, albeit based on small numbers of deaths. The fact that the link between obesity and PCSM was stronger than with recurrence suggests that either recurrences are more aggressive or obesity predicts poorer responses to salvage therapies such as hormonal therapy. To test the idea that more aggressive recurrences explain the stronger link with PCSM than with recurrence, we examined the association between body mass index (BMI) and aggressive recurrence, as measured by PSA doubling time (PSADT) using the Shared Equal Access Regional Cancer Hospital (SEARCH) database. METHODS We examined the association between BMI and biochemical recurrence among 4,123 men treated with radical prostatectomy between 1988 and 2016 within the SEARCH Database using a Cox model. Among men with a biochemical recurrence, PSADT was compared across BMI categories using linear regression. Models were adjusted for age, race, PSA, biopsy Gleason score, clinical stage, year, and surgical center. RESULTS Overall, 922 men (23%) were normal weight (BMI <25 kg/m2), 1863 (45%) were overweight (BMI 25-29.9 kg/m2), 968 (23%) were obese (BMI 30-34.9 kg/m2), and 370 (9%) were moderately or severely obese (BMI =35 kg/m2). After adjustment for multiple clinical characteristics, higher BMI was significantly associated with higher risk of biochemical recurrence (p=0.008). However, among men with a biochemical recurrence, men in the four BMI categories had similar multivariable adjusted PSADT values (increasing BMI categories: 20.9 vs. 21.3 vs. 21.0 vs. 14.9 months, p=0.27). CONCLUSIONS We confirmed that men with higher BMI were more likely to have biochemical recurrence. However, we also found no link between BMI and PSADT at the time of recurrence. Given the known stronger association between obesity and increased risk of PCSM after radical prostatectomy versus recurrence in general, our data suggest that the strength of the association with PCSM is not due to more aggressive recurrences among obese men. Future studies are needed in regards to obesity and response to salvage therapies. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e442 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Brandee Branche More articles by this author Lauren Howard More articles by this author Robert Hamilton More articles by this author William Aronson More articles by this author Martha Terris More articles by this author Matthew Cooperberg More articles by this author Christopher Amling More articles by this author Christopher Kane More articles by this author Stephen Freedland More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...