Correlation of High Body Mass Index With More Advanced Localized Prostate Cancer at Radical Prostatectomy Is Not Reflected in PSA Level and PSA Density but Is Seen in PSA Mass

Kryvenko, Oleksandr N.; Epstein, Jonathan I.; Meier, Frederick A.; Gupta, Nilesh; Menon, Mani; Diaz, Mireya

doi:10.1309/ajcpql9mkq6vddwl

Cited by 16 publications

(11 citation statements)

References 37 publications

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“…We found that although BMI is not an independent risk factor for the development of PCa, it is associated with HGPCa. These results are consistent with an earlier study of 4,926 American patients by Kryvenko et al [ 22 ]. The samples collected by Kryvenko et al were from Western world patients and they may differ from Asian population in several clinicopathological aspects.…”

Section: Discussionsupporting

confidence: 94%

Correlation between body mass index (BMI) and the Gleason score of prostate biopsies in Chinese population

Zhou

Chen

et al. 2016

Oncotarget

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We assessed the correlation between BMI and Gleason score in prostate biopsies in Chinese Population. In this retrospective study, we collected the Gleason score, PSA, BMI, age, race, and other related clinical data on 290 patients who had undergone prostatic biopsy. We then compared the prostate cancer detection rates and Gleason scores between the high BMI group (BMI ≥ 25; 143 cases) and low BMI group (< 25; 147 cases). Among the 137 patients in whom prostate cancer detected, 70 had high BMIs and 67 had normal BMIs, making the detection rates 48.95% and 45.58% respectively. Seventeen prostate cancer patients had low Gleason scores (Gleason score < 7), while 120 had high Gleason scores (≥ 7). Within the high BMI group, 44.76% had high Gleason scores, which was significantly greater than the 38.10% in the low BMI group (P = 0.027). These results indicate that while there was no effect of BMI on the rate of positive prostate cancer biopsies, the rate of high Gleason scores was greater in the high BMI group than the normal BMI group.

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Section: Discussionsupporting

confidence: 94%

Correlation between body mass index (BMI) and the Gleason score of prostate biopsies in Chinese population

Zhou

Chen

et al. 2016

Oncotarget

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“…1,6,12,17 PSA mass (PSAM) was calculated by multiplying plasma volume (L) by PSA. 18 Plasma volume was calculated by multiplying estimated body surface area (m 2 ) by a 1.67 adjustment factor. Estimated body surface area was calculated by the following formula: (body weight, kg) 0.425 *(height, m) 0.72 *0.007184.…”

Section: Methodsmentioning

confidence: 99%

“…Estimated body surface area was calculated by the following formula: (body weight, kg) 0.425 *(height, m) 0.72 *0.007184. 18 PSA mass density (PSAMD) was calculated by dividing PSAM (μg) by prostate weight (g) without SV. 17,19 …”

Section: Methodsmentioning

confidence: 99%

Radical Prostatectomy Findings in White Hispanic/Latino Men With NCCN Very Low-risk Prostate Cancer Detected by Template Biopsy

Kryvenko

Lyapichev

Chinea

et al. 2016

American Journal of Surgical Pathology

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Radical prostatectomy (RP) outcomes have been studied in White and Black non-Hispanic men qualifying for Epstein active surveillance criteria (EASC). Herein, we first analyzed such outcomes in White Hispanic men. We studied 70 men with nonpalpable Gleason score 3+3 = 6 (Grade Group [GG] 1) prostate cancer (PCa) with ≤2 positive cores on biopsy who underwent RP. In 18 men, prostate-specific antigen (PSA) density (PSAD) was >0.15 ng/mL/g. Three of these had insignificant and 15 had significant PCa. The remaining 52 men qualified for EASC. One patient had no PCa identified at RP. Nineteen (37%) had significant PCa defined by volume (n = 7), grade (n = 7), and volume and grade (n = 5). Nine cases were 3+4 = 7 (GG 2) (5/9 [56%] with pattern 4 <5%), 2 were 3+5 = 8 (GG 4), and 1 was 4+5 = 9 (GG 5). Patients with significant PCa more commonly had anterior dominant disease (11/19, 58%) versus patients with insignificant cancer (7/33, 21%) (P = 0.01). In 12 cases with higher grade at RP, the dominant tumor nodule was anterior in 6 (50%) and posterior in 6 (median volumes: 1.1 vs. 0.17 cm3, respectively; P = 0.01). PSA correlated poorly with tumor volume (r = 0.28, P = 0.049). Gland weight significantly correlated with PSA (r = 0.54, P < 0.001). While PSAD and PSA mass density correlated with tumor volume, only PSA mass density distinguished cases with significant disease (median, 0.008 vs. 0.012 μg/g; P = 0.03). In summary, a PSAD threshold of 0.15 works well in predicting significant tumor volume in Hispanic men. EASC appear to perform better in White Hispanic men than previously reported outcomes for Black non-Hispanic and worse than in White non-Hispanic men. Significant disease is often Gleason score 3+3 = 6 (GG 1) PCa >0.5 cm3. Significant PCa is either a larger-volume anterior disease that may be detected by multi-parametric magnetic resonance imaging-targeted biopsy or anterior sampling of the prostate or higher-grade smaller-volume posterior disease that in most cases should not pose immediate harm and may be detected by repeat template biopsies.

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“…For PSAM, plasma volume was multiplied by the preoperative serum PSA level [18]. The plasma volume was determined by multiplying the estimated body surface area (m 2 ) by a 1.67 adjustment factor.…”

Section: Methodsmentioning

confidence: 99%

“…A hemodilution effect has also been discussed with overweight and obese men having disproportionally lower serum PSA levels [14]. PSA mass (PSAM) accounts for this effect and also improves correlation with TV, although it does not account for PW [18]. Through incorporation of PSAM and PSAD, PSA mass density (PSAMD) accounts for both PW and BMI, potentially improving correlations with TV compared to PSA or PSAD [15].…”

Section: Introductionmentioning

confidence: 99%

Understanding PSA and its derivatives in prediction of tumor volume: addressing health disparities in prostate cancer risk stratification

et al. 2017

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ObjectivesTo address health disparities in risk stratification of U.S. Hispanic/Latino men by characterizing influences of prostate weight, body mass index, and race/ethnicity on the correlation of PSA derivatives with Gleason score 6 (Grade Group 1) tumor volume in a diverse cohort.ResultsUsing published PSA density and PSA mass density cutoff values, men with higher body mass indices and prostate weights were less likely to have a tumor volume <0.5 cm3. Variability across race/ethnicity was found in the univariable analysis for all PSA derivatives when predicting for tumor volume. In receiver operator characteristic analysis, area under the curve values for all PSA derivatives varied across race/ethnicity with lower optimal cutoff values for Hispanic/Latino (PSA=2.79, PSA density=0.06, PSA mass=0.37, PSA mass density=0.011) and Non-Hispanic Black (PSA=3.75, PSA density=0.07, PSA mass=0.46, PSA mass density=0.008) compared to Non-Hispanic White men (PSA=4.20, PSA density=0.11 PSA mass=0.53, PSA mass density=0.014).Materials and MethodsWe retrospectively analyzed 589 patients with low-risk prostate cancer at radical prostatectomy. Pre-operative PSA, patient height, body weight, and prostate weight were used to calculate all PSA derivatives. Receiver operating characteristic curves were constructed for each PSA derivative per racial/ethnic group to establish optimal cutoff values predicting for tumor volume ≥0.5 cm3.ConclusionsIncreasing prostate weight and body mass index negatively influence PSA derivatives for predicting tumor volume. PSA derivatives’ ability to predict tumor volume varies significantly across race/ethnicity. Hispanic/Latino and Non-Hispanic Black men have lower optimal cutoff values for all PSA derivatives, which may impact risk assessment for prostate cancer.

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Correlation of High Body Mass Index With More Advanced Localized Prostate Cancer at Radical Prostatectomy Is Not Reflected in PSA Level and PSA Density but Is Seen in PSA Mass

Cited by 16 publications

References 37 publications

Correlation between body mass index (BMI) and the Gleason score of prostate biopsies in Chinese population

Correlation between body mass index (BMI) and the Gleason score of prostate biopsies in Chinese population

Radical Prostatectomy Findings in White Hispanic/Latino Men With NCCN Very Low-risk Prostate Cancer Detected by Template Biopsy

Understanding PSA and its derivatives in prediction of tumor volume: addressing health disparities in prostate cancer risk stratification

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