Obesity is Associated with Longer Survival Independent of Sarcopenia and Myosteatosis in Metastatic and/or Castrate-Resistant Prostate Cancer

Xu, Mark C.; Huelster, Heather; Hatcher, Jeremy B; Avulova, Svetlana; Stocks, Blair T.; Glaser, Zachary A.; Moses, Kelvin A.; Silver, Heidi J.

doi:10.1097/ju.0000000000001428

Cited by 18 publications

(29 citation statements)

References 28 publications

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“…Although the beneficial influence of adiposity has been presumed to be attributed to their protectiveness with respect to muscle loss, 28 our study showed contrasting results, indicating that the association between adiposity and OS was independent of skeletal muscle mass status and SMI. Notably, there was a tendency for visceral adiposity, rather than subcutaneous adiposity, to be associated with improved OS, which was also comparable with results of previous studies by Xu et al 23 . and Hong et al 29 .…”

Section: Discussionsupporting

confidence: 90%

Obesity is associated with improved postoperative overall survival, independent of skeletal muscle mass in lung adenocarcinoma

Lee

Yoon

Kim

et al. 2022

J cachexia sarcopenia muscle

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Background Although the obesity paradox is a topic of immense interest for oncologists and epidemiologists, the mechanism underlying this unexpected benefit of obesity is poorly understood. We explored the prognostic value of obesity and its association with skeletal muscle mass. Methods This retrospective study evaluated the data of patients who underwent surgical excision for lung adenocarcinoma between January 2011 and December 2015. Body mass index was categorized according to the criteria of the Asia‐Pacific classification. Cross‐sectional areas of the skeletal muscle, subcutaneous fat, and visceral fat were measured. Skeletal muscle mass status was defined based on the cut‐offs of skeletal muscle index (cm2/m2), calculated as the area of skeletal muscle divided by height squared. Overall survival was estimated using the Kaplan–Meier method, and differences in survival probabilities were compared using the log‐rank test. Cox proportional hazards regression analysis was conducted to determine the association with overall survival. Results A total of 636 patients with a median age of 61 years (interquartile range, 54.0–68.5 years; 321 men and 315 women) were included. Obese patients (body mass index ≥ 25 kg/m2) had longer overall survival than non‐obese patients (mean, 110.2 months vs. 98.7 months; log‐rank P = 0.015). Under multivariable Cox proportional hazard regression analysis, obesity was associated with longer overall survival after adjusting for covariates (hazard ratio, 0.59; 95% confidence interval, 0.40–0.86; P = 0.007). The prognostic value of obesity remained and predicted favourable overall survival after additional adjusting for skeletal muscle mass status (hazard ratio, 0.57; 95% confidence interval, 0.36–0.89; P = 0.014), skeletal muscle index (hazard ratio, 0.53; 95% confidence interval, 0.33–0.84; P = 0.008), or skeletal muscle area (hazard ratio, 0.61; 95% confidence interval, 0.38–0.98; P = 0.041). No association was observed between skeletal muscle mass status and the impact of body mass index on overall survival (P for interaction = 0.512). Conclusions Obesity was associated with favourable overall survival, independent of skeletal muscle mass, after surgical excision of lung adenocarcinoma.

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Section: Discussionsupporting

confidence: 90%

Obesity is associated with improved postoperative overall survival, independent of skeletal muscle mass in lung adenocarcinoma

Lee

Yoon

Kim

et al. 2022

J cachexia sarcopenia muscle

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“…1 and Supplementary eAppendix 2). A total of 16 cohort studies undertaking retrospective analyses [16,24,25,[33][34][35][36][37][38][39][40][41][42][43][44][45] were included in the primary analysis. During the eligibility assessment, six additional studies [46][47][48][49][50][51] were initially selected and authors contacted given the lack of specific information on the results for prostate cancer patients.…”

Section: Studies Included and Characteristicsmentioning

confidence: 99%

“…In summary, a total of 4807 prostate cancer patients with a median age of 69.0 years (interquartile range (IQR): 67.2-71.3) and BMI of 26.6 kg m −2 (IQR: 24.3-28.7) participated in the included studies. All studies except one derived fat and muscle mass measures from CT scans [16,24,25,[34][35][36][37][38][39][40][41][42][43][44][45]. Most studies (n = 11) included advanced prostate cancer patients (e.g., metastatic, castration-resistant or metastatic castration-resistant patients) [16,24,34,35,38,39,[41][42][43][44][45], and the majority of patients received treatments such as radiotherapy [33,[36][37][38][39][40][41][42][43] and ADT [33,[35][36][37][40][41][42][43][44] (n = 9 for both), followed by surgery [25,33,…”

Section: Studies Included and Characteristicsmentioning

confidence: 99%

“…This apparent obesity paradox may be related to the reliance on BMI since this measure does not differentiate lean from fat mass or visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) [17,18], masking the relationship of fat mass with overall survival in men with prostate cancer [19,20]. Furthermore, sarcopenia or the loss of muscle mass has also been considered an important prognostic factor [6,[21][22][23], although its association with overall survival in men with prostate cancer is largely controversial depending on the cancer stage or phase of treatment [16,24,25]. Therefore, it remains to be determined if excess fat mass, reduced levels of muscle mass, or both treatment-related changes in body composition have an impact on overall survival in men with prostate cancer [20].…”

Section: Introductionmentioning

confidence: 99%

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Associations of fat and muscle mass with overall survival in men with prostate cancer: a systematic review with meta-analysis

López

Newton

Taaffe

et al. 2021

Prostate Cancer Prostatic Dis

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Background To systematically review and analyse the associations between fat and muscle mass measures with overall survival in men with prostate cancer. Methods A systematic search was conducted in CINAHL, Cochrane Library, EMBASE, PubMed, and Web of Science databases from inception to December 2020, while abstracts from the American Society of Clinical Oncology (ASCO), Clinical Oncology Society of Australia (COSA), and the American College of Sports Medicine (ACSM) conferences were searched from 2014 to 2020. Eligible articles examined the association of body composition measures, such as fat mass (e.g., fat mass, visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT), and VAT/SAT) and muscle mass measures, with overall survival in prostate cancer patients at any treatment stage. The primary endpoint was overall survival. Random-effect meta-analysis was conducted for studies reporting multivariable or univariable analysis assessing the associations of fat mass measures (i.e., fat mass, VAT, SAT, VAT/SAT) and muscle mass measures with overall survival. Results Sixteen cohort studies that comprised 4807 men with prostate cancer were included. Total adiposity (hazard ratio (HR) 0.98, 95% CI: 0.75–1.28, p = 0.888) and VAT (HR 1.03, 95% CI: 0.74–1.43, p = 0.873) were not significantly associated with overall survival, while higher subcutaneous adipose tissue levels were associated with higher survival (HR 0.68, 95% CI: 0.54–0.84, p = 0.001). Greater mortality risk was found in patients with localised (HR 1.91, 95% CI: 1.40–2.62, p < 0.001) and advanced disease (HR 1.43, 95% CI: 1.07–1.92, p = 0.020) presenting with low levels of muscle mass compared to those presenting with high levels. Discussion These results indicate that although overall adiposity should be cautiously interpreted in regards to survival, high muscle mass and SAT, and low VAT/SAT ratio values are associated with overall survival in men with prostate cancer.

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“…This is an important issue when counseling PCa patients for RARP because the detection of PSM represents an unfavorable pathological outcome that adversely impacts the natural history of the disease for biochemical recurrence, metastatic progression, and disease-specific mortality [20]. Additionally, it is known that obese patients represent a special [20,[28][29][30][31][32].…”

Section: Discussionmentioning

confidence: 99%

ABO blood group system and risk of positive surgical margins in patients treated with robot-assisted radical prostatectomy: results in 1114 consecutive patients

et al. 2021

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To test the hypothesis of associations between the ABO blood group system (ABO-bg) and prostate cancer (PCa) features in the surgical specimen of patients treated with robot-assisted radical prostatectomy (RARP). Between January 2013 and October 2020, 1114 patients were treated with RARP. Associations of ABO-bg with specimen pathological features were evaluated by statistical methods. Overall, 305 patients were low risk (27.4%), 590 intermediate risk (50%) and 219 high risk (19.6%). Pelvic lymph node dissection was performed in 678 subjects (60.9%) of whom 79 (11.7%) had cancer invasion. In the surgical specimen, tumor extended beyond the capsule in 9.8% and invaded seminal vesicles in 11.8% of cases. Positive surgical margins (PSM) were detected in 271 cases (24.3%). The most frequently detected blood groups were A and O, which were equally distributed for both including 467 patients (41.9%), followed by groups B (127 cases; 11.4%) and AB (53 subjects; 4.8%). Among specimen factors, the ABO-bgs associated only with the risk of PSM, which was higher for blood group O (30.4%) compared with group A (19.5%) after adjusting for other standard clinical predictors (odds ratio, OR = 1.842; 95% CI 1.352–2.509; p < 0.0001). Along the ABO-bgs, the risk of PSM was increased by group O independently by other standard preoperative factors. The ABO-bgs may represent a further physical factor for clinical assessment of PCa patients, but confirmatory studies are required.

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Obesity is Associated with Longer Survival Independent of Sarcopenia and Myosteatosis in Metastatic and/or Castrate-Resistant Prostate Cancer

Cited by 18 publications

References 28 publications

Obesity is associated with improved postoperative overall survival, independent of skeletal muscle mass in lung adenocarcinoma

Obesity is associated with improved postoperative overall survival, independent of skeletal muscle mass in lung adenocarcinoma

Associations of fat and muscle mass with overall survival in men with prostate cancer: a systematic review with meta-analysis

ABO blood group system and risk of positive surgical margins in patients treated with robot-assisted radical prostatectomy: results in 1114 consecutive patients

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