TITLE:
The Effect of Obesity and Diabetes on Intermediate to High Grade Prostate Cancer Patients Treated with Radical Prostatectomy
AUTHORS:
Emma H. Ramahi, Katherine C. Ansley, Gregory P. Swanson, Fei Du, Joseph W. Basler
KEYWORDS:
Obesity; Diabetes Mellitus; Prostatectomy; Prostatic Neoplasms; Therapy; Treatment Outcomes
JOURNAL NAME:
Open Journal of Urology,
Vol.2 No.1,
March
9,
2012
ABSTRACT: Aims: The relationships between obesity, diabetes and prostate cancer are unclear. A retrospective study was performed to determine the effects of body mass index (BMI) and diabetes on patients with intermediate to high grade prostate cancer treated with radical prostatectomy. Methods: We reviewed 582 patients with Gleason score ≥ 7 non-metastatic prostate cancer treated with radical prostatectomy. Patients were stratified by BMI. End points were biochemical failure free survival (BFFS), overall survival (OS), and cancer specific survival (CSS). Results: Mean pre-treatment PSA decreased with increasing BMI (12.5, 7.6, 7.8 and 5.3 ng/mL with BMI 35, respectively; p 35, respectively. However, for overall mortality the adjusted hazard ratio was 0.39 (0.18, 0.82; p = 0.01) for overweight patients (BMI 25 - 30) compared to patients with a BMI in the normal range. Patients with a BMI of 30 - 35 and > 35 had increased rates of positive margins than those with a BMI of 25 - 30 or 35 2.04) on multivariate analysis, margin positivity alone was not a significant factor. Conclusions: Patients with increasing BMI tend to have a lower PSA at diagnosis but are more likely to have biochemical failure after radical prostatectomy. In our cohort, this was not due to the increased incidence of positive margins. Having diabetes had no effect.