The relationship between body-mass index, physical activity, and pathologic and clinical outcomes after radical prostatectomy for prostate cancer.

Abstract

PURPOSE:

We evaluated whether an increased body-mass index (BMI) and decreased physical activity increase the risk of locally advanced or high-risk prostate cancer (PCa) at radical prostatectomy (RP), and treatment failure after surgery.

METHODS:

Data were collected from the PROCURE Biobank, a prospective cohort of patients with localized PCa undergoing RP in four academic centers in Québec between 2006 and 2013. Treatment failure was defined as biochemical recurrence and/or initiation of secondary, non-adjuvant therapy, and analyzed using the Kaplan-Meier method, log-rank tests, and Cox proportional-hazards models. Uni- and multivariate (ordered) logistic regression was used for time-independent variables.

RESULTS:

1813 patients were included. Median follow-up time was 69 months. Patients who reported a lower BMI were generally older, of Asian descent, and physically more active (p < 0.05). Younger, black, and overweight/obese patients reported less physical activity (p < 0.05). In multivariate analyses, a higher BMI increased the risk for locally advanced, high-risk PCa (defined as a pT3, N1 and/or Gleason 8-10 tumor; odds ratio 1.33, p < 0.001), but increased physical activity did not predict high-risk disease (odds ratio 0.84, p = 0.39). Patients with a higher BMI also had a larger prostate at surgery (odds ratio 1.13, p = 0.03). BMI and physical activity were not associated with positive surgical margins or time to treatment failure (p > 0.05).

CONCLUSIONS:

BMI was an independent predictor for locally advanced, high-risk disease in this cohort of PCa patients undergoing RP, but was unrelated to treatment failure. Physical activity was not related to locally advanced, high-risk PCa or treatment failure.

• Authors: Michel Wissing, Simone Chevalier, Ginette McKercher, Claudie Laprise, Saro Aprikian, Ana O'Flaherty, Eleonora Scarlata, Fred Saad, Michel Carmel, Louis Lacombe, Fadi Brimo, Mathieu Latour, Nadia Ekindi-Ndongo, Bernard Têtu, Armen Aprikian
• Journal: World journal of urology (World J Urol) Vol. 37 Issue 5 Pg. 789-798 (May 2019) ISSN: 1433-8726 [Electronic] Germany
• PMID: 30136199 (Publication Type: Journal Article)

Topics

• Adult
• Aged
• Aged, 80 and over
• Body Mass Index
• Cohort Studies
• Exercise
• Humans
• Logistic Models
• Male
• Margins of Excision
• Middle Aged
• Multivariate Analysis
• Obesity (epidemiology)
• Proportional Hazards Models
• Prospective Studies
• Prostatectomy
• Prostatic Neoplasms (epidemiology, pathology, surgery)
• Treatment Failure
• Treatment Outcome