Impact of obesity on functional and oncological outcomes in radical perineal prostatectomy

Abstract

Introduction:We evaluated the impact of obesity on perioperative morbidity, functional, and oncological outcomes after radical perineal prostatectomy (RPP). Methods: A total of 298 consecutive patients underwent RPP at our institution. Patients were categorized into 3 groups based on their body mass index (BMI): Normal weight <25 kg/m 2 (Group 1), overweight 25 to <30 kg/m 2 (Group 2), and obese ≥30 kg/m 2 (Group 3). We compared the groups with respect to perioperative data, postoperative oncologic, and functional outcomes. Evaluation of urinary continence and erectile function was performed using a patient-reported questionnaire and the International Index of Erectile Function-5 questionnaire, respectively, administered preoperatively and at 3, 6, and 12 months. Limitations included short follow-up time, retrospective design and lack of a morbidly obese group. Results: No significant differences were found among the 3 groups with regard to operative time, estimated blood loss, length of hospital stay, catheter removal time, positive surgical margin, and complication rates. At 12 months, 94.7%, 95% and 95% of normal, overweight and obese patients, respectively, were continent (free of pad use) (p = 0.81). At 12 months, 30.6%, 29.8% and 30.4% of patients had spontaneous erections and were able to penetrate and complete intercourse in Group 1, Group 2, and Group 3, respectively (p = 0.63). Conclusions:In this cohort of patients, no clinically relevant risks were associated with increasing BMI.

Obesity is Associated with Upgrading in Prostate Cancers

“…Authors from Turkey reported that obesity did not correlate with worse oncological and functional outcomes in patients who underwent radical perineal prostatectomy. 2 The present study has shown that obesity is associated with upgrading (p=0.043) and the rate of locally advanced disease HGPCA was higher in obese patients than in the others.…”

“…The positive surgical margin rate was reported between 6.1 and 53% in the studies. 2,11 There was signifi cant difference for positive surgical margin between BMI categories 11 , the other study revealed that the rate of positive surgical margin is lower (6.1%) in patients with BMI >30 kg/m 2 than BMI <25 kg/m 2 (6.9%) with no signifi cant difference. The present study revealed that the positive surgical margin is lower in obese men than in the others with an incidence of 5.55%.…”

“…The age and PSA level of the patients with high BMI are different in the studies. While Altay et al 2 and Amling et al 12 reported that increased BMI was positively correlated with PSA levels, Freedland at al. 11 found that BMI was associated lower PSA levels.…”

“…The studies of Freedland at al. 11 and Amling et al 12 showed that patients with high BMI were younger, Altay et al 2 reported that the age at presentation of the obese patients was higher than that of the others. In the present study, the patients with high BMI were younger with high PSA levels than the other patients.…”

“…Obesity and overweight affect more than 30% of the population in United States according to the World Health Organization criteria. 2 Two-thirds of them are overweight (body mass index, BMI≥25 kg/m 2 ) and one-third are obese (BMI≥30 kg/m 2 ). 1 The relationship between obesity and prostate cancer is unclear.…”