Pathologic Variables and Recurrence Rates As Related to Obesity and Race in Men With Prostate Cancer Undergoing Radical Prostatectomy

Amling, Christopher L.; Riffenburgh, Robert H.; Sun, Leon; Moul, Judd W.; Lance, Raymond S.; Kusuda, Leo; Sexton, Wade J.; Soderdahl, Douglas W.; Donahue, Timothy F.; Foley, John P.; Chung, Andrew; McLeod, David G.

doi:10.1200/jco.2004.03.132

Cited by 350 publications

(288 citation statements)

References 33 publications

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“…The investigators suggested that obesity in the African-American population may, in part, underlie the increased prostate cancer risk among African Americans. 6 In our study, the association between ethnicity and either BMI or 2 or greater remained a significant independent predictor of PSA failure. After patients were divided into groups by each 2.5-kg/m 2 separation in BMI, the risk of PSA failure did not dramatically increase until the BMI was 35 kg/m 2 or greater.…”

Section: Resultssupporting

confidence: 47%

“…In a study of 135,000 Swedish construction workers 3 and in two large American Cancer Society cohorts, 11 the prostate cancer mortality rates were consistently greater in patients with a greater BMI, suggesting a greater influence of body mass on prostate cancer aggression, rather than on prostate cancer incidence. 6 Likewise, an analysis from CaPSURE previously found a positive correlation between a greater BMI (Ͼ25 kg/m 2 ) and the risk of being in a worse prognostic group at diagnosis (P ϭ 0.018). 12 It is less clear how obesity affects prostate cancer outcomes after RP.…”

Section: Resultsmentioning

confidence: 90%

“…[3][4][5] Two recent, retrospective, multi-institutional studies have reported greater recurrence rates among obese patients after radical prostatectomy (RP). 6,7 Obesity was an independent predictor of recurrence in one but not in the other. We sought to evaluate the independent relationship of obesity to prostate cancer recurrence after treatment with RP using a large, community-based prostate cancer database.…”

Section: Authorsmentioning

confidence: 78%

“…Amling et al 6 analyzed 3162 patients from the Center for Prostate Cancer Research database who underwent RP between 1987 and 2002. Two BMI categories were used for the analysis: the normal and overweight patients were combined to form one group (BMI less than 30 kg/m 2 ) and compared with the obese group (BMI greater than 30 kg/m 2 ).…”

Section: Resultsmentioning

confidence: 99%

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Impact of obesity on prostate cancer recurrence after radical prostatectomy: Data from CaPSURE

Bassett

Cooperberg

Sadetsky

et al. 2005

Urology

123

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Objectives. To determine the association between obesity and prostate cancer recurrence after primary treatment with radical prostatectomy. Methods. Data were abstracted from CaPSURE, a disease registry of 10,018 men with prostate cancer. We included 2131 men who had undergone radical prostatectomy between 1989 and 2003 and had body mass index (BMI) information available. Recurrence was defined as two consecutive prostate-specific antigen (PSA) levels of 0.2 ng/mL or greater or any second treatment. Patients were risk stratified using the PSA level, Gleason grade, and clinical T stage. Results. Patients were followed up for a median of 23 months. Of the 2131 patients, 251 (12%) developed recurrence at a median of 13 months (range 1 to 107); 183 (9%) of these men had PSA failure and 68 (3%) received a second treatment. After adjusting for risk group, ethnicity, age, and comorbidities, a significant association was found between an increasing BMI and disease recurrence (P ϭ 0.028). Very obese patients (BMI 35 kg/m 2 or more) were 1.69 times more likely to have recurrence relative to men of normal weight (BMI less than 25.0 kg/m 2 ; 95% confidence interval [CI] 1.01 to 2.84). An increasing PSA level (P Ͻ0.0001) and Gleason grade (P Ͻ0.0001) were also associated with recurrence. Ethnicity was not significantly associated with either BMI or PSA recurrence (P ϭ 0.685 and P ϭ 0.068, respectively). Conclusions. The results of our study have shown that obesity is an independent predictor of prostate cancer recurrence. Because of the increased comorbidities and greater rates of recurrence, obese individuals undergoing radical prostatectomy need vigilant follow-up care. UROLOGY 66: 1060-1065, 2005.

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Section: Resultssupporting

confidence: 47%

Section: Resultsmentioning

confidence: 90%

Section: Authorsmentioning

confidence: 78%

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Impact of obesity on prostate cancer recurrence after radical prostatectomy: Data from CaPSURE

Bassett

Cooperberg

Sadetsky

et al. 2005

Urology

123

View full text Add to dashboard Cite

show abstract

“…Few studies focused on this issue. An elevated BMI is a risk factor for the occurrence of several cancers (Moertel et al, 1980;Calle et al, 2003), and is associated with a higher relapse rate after surgical treatment of colon, rectal and prostate cancer (Meyerhardt et al, 2003;Amling et al, 2004;Freedland et al, 2004;Meyerhardt et al, 2004). However, its impact on disease's natural history and response to treatment is less documented.…”

Section: Discussionmentioning

confidence: 99%

Arterial phase enhancement and body mass index are predictors of response to chemoembolisation for liver metastases of endocrine tumours

et al. 2006

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Transcatheter arterial chemoembolisation (TACE) has been reported to be an efficient treatment of liver metastases of endocrine tumours in short series of patients. However, several factors seem to affect its results. The aim of this work is to identify predictors of response to TACE for liver metastases of endocrine tumours. A total of 163 TACE procedures were performed in 67 patients between 1994 and 2004. Forty-four patients were treated with streptozotocin and 23 with doxorubicin. Primary tumour was located in the pancreas for 19 patients, and had been removed in 43. Thirty-eight tumours were functioning. Response rate was 37% (confidence interval [CI] 95%: 28 -49%). Median time to progression (TTP) was 14.5 months (CI 95%: 9 -41). In multivariate analysis (n ¼ 43), predictors of tumour response were body mass index (BMI) (odds ratio [OR]: 1.3; CI 95%: 1.04 -1.63; P ¼ 0.022), functioning type of tumour (OR: 7.31; CI 95%: 1.26 -42.5; P ¼ 0.027), arterial phase enhancement on abdominal computed tomography (CT) (OR: 8.11; CI 95%:1.06 -62; P ¼ 0.044) and use of streptozotocin for cytotoxic agent (OR: 21.3; CI 95%: 1.48 -306; P ¼ 0.025). Analysis of TTP predictors showed that BMI (hazard ratio [HR]: 0.85; CI 95%: 0.76 -0.86; P ¼ 0.01) and arterial phase enhancement (HR: 0.3; CI 95%: 0.12 -0.73; P ¼ 0.008) were associated with delayed progression. This large study confirms the previously reported results of TACE regarding its efficacy for the treatment of liver metastases of endocrine tumours. Arterial phase enhancement on abdominal CT and BMI are predictors of treatment's efficacy. Streptozotocin should be the preferred cytotoxic agent in order to save anthracycline for systemic chemotherapy.

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Risk of Advanced Papillary Thyroid Cancer in Obese Patients

Harari¹,

Endo²,

Nishimoto³

et al. 2012

Arch Surg

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To determine whether increasing body mass index (BMI) is associated with more aggressive disease and adverse surgical outcomes in patients with papillary thyroid cancer (PTC). Design: Retrospective review of a prospective database. Setting: Single academic tertiary care center. Patients: A total of 443 patients older than 18 years who underwent total thyroidectomy for PTC from January 1, 2004, through March 31, 2011, were included in the analysis. Patients were organized into 4 BMI (calculated as weight in kilograms divided by height in meters squared) groups: normal (18.5-24.9), overweight (25-29.9), obese (30-39.9), and morbidly obese (Ն40). Main Outcome Measures: Disease stage at presentation, histologic subtype, duration of anesthetic induction and extubation, duration of surgery, surgical complications, length of hospital stay, and American Society of Anesthesiologists (ASA) class. Results: Ages ranged from 18 to 89 years. Greater BMI was associated with more advanced disease stage at presentation (P Ͻ .001) and more aggressive PTC histopathologic subtype (P=.03). Morbidly obese patients presented more frequently with stage III or IV disease (odds ratio, 3.67; PϽ.001). Greater BMI was also associated with longer duration of anesthetic induction (P Ͻ .001), increased length of stay (P Ͻ.001), and higher ASA class (PϽ .001). Duration of surgery was not associated with BMI. There was a trend toward larger tumors with increasing BMI (P=.06). Obese BMI was associated with more preoperative vocal cord paralysis due to local invasion (odds ratio, 9.21; P=.001). Conclusions: Obese patients present with more advanced stage and more aggressive forms of PTC. This finding suggests that obese patients should be screened for thyroid cancer.

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Pathologic Variables and Recurrence Rates As Related to Obesity and Race in Men With Prostate Cancer Undergoing Radical Prostatectomy

Cited by 350 publications

References 33 publications

Impact of obesity on prostate cancer recurrence after radical prostatectomy: Data from CaPSURE

Impact of obesity on prostate cancer recurrence after radical prostatectomy: Data from CaPSURE

Arterial phase enhancement and body mass index are predictors of response to chemoembolisation for liver metastases of endocrine tumours

Risk of Advanced Papillary Thyroid Cancer in Obese Patients

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