Effect of obesity on the prognosis and recurrence of prostate cancer after radical prostatectomy: a meta-analysis

Abstract

Background: Obesity has been found to be closely related to the increased risk of fatal prostate cancer (PCa), however there remains no evidence that further clarifies the relationship between obesity and the postoperative recurrence and poor prognosis of PCa. In this study, a systematic review and meta-analysis were performed to systematically evaluate the effect of obesity on the prognosis and recurrence of PCa after radical prostatectomy (RP).Methods: A literature search of the PubMed, Web of Science, and Embase databases was performed covering articles published between January 2013 and January 2020. Articles regarding the correlation between body mass index (BMI) and the prognosis and recurrence of PCa following RP were included in the meta-analysis. Two investigators independently screened the literature and extracted relevant data including publication information, key results, number of cancer cases, and multivariable-adjusted odds ratios (ORs) with 95% confidence intervals (CIs). Meta-analysis was performed using RevMan 5.3 and Stata 16.0 software, and forest plots, funnel plots, and sensitivity analysis were also conducted.Results: A total of 14 articles were included, all of which were analyzed for clinicopathological characteristics. Eight articles reported the biochemical recurrence (BCR) with prostate-specific antigen (PSA) as the predictor, and six articles reported the positive surgical margins (PSM). The meta-analysis showed that obese PCa patients had more postoperative recurrence and poor prognosis compared with the normal weight PCa patients, and the difference was statistically significant (OR =1.25, 95% CI: 1.10, 1.43). BCR exhibited no significant difference between obese and non-obese PCa patients after surgery (OR =1.2, 95% CI: 0.96, 1.46), and there were also no notable differences in PSM between the groups (OR =1.16, 95% CI: 0.99, 1.36).Subgroup analysis showed that obese PCa patients in the Americas (95% CI: 1.11, 1.37) and Europe (95% CI: 1.11, 1.78) were more likely to have surgical recurrence and poor prognosis (OR =1.40). Obese patients in the Americas were also more likely to have BCR after surgery (95% CI: 1.07, 1.36).Conclusions: Obesity easily leads to poor prognosis and recurrence of PCa after RP.

Excess weight, weight gain, and prostate cancer risk and prognosis: the PROCA-life study

“…They observed that smoking status modified the relationship between BMI and fatal PCa. Additionally, obesity may also be a risk factor for complications during surgery, and side effects from oncological treatment [50]. Furthermore, our study observed a lower risk of overall mortality among PCa cases with weight gain, which is in part supported by findings in the same study population who found that men with a weight loss had higher all-cause mortality [51].…”

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Elucidating the interplay between prostate cancer, education, and fat intake through causal inference and mediation analysis

“…We applied a 10 Mb clumping window with a rigorous r2 cutoff of 0.001 to remove SNPs in linkage disequilibrium and retained only those with the lowest P-value. Utilizing the PhenoScanner database, we screened and excluded SNPs associated with plausible confounders (tobacco smoking, alcohol consumption, and obesity (13)(14)(15)). Furthermore, we performed MR pleiotropy residual sum and outlier (MR-PRESSO) test before MR analysis to examine whether horizontal pleiotropy existed.…”