Prognostic impact of abdominal adiposity, waist circumference and body mass index in patients with intermediate-risk prostate cancer treated with radiotherapy

Abstract

Objective: We tested the potential role of abdominal visceral (VAT) and subcutaneous (SAT) adipose tissues, waist circumference (WC) and body mass index (BMI) as prognostic factors in patients with intermediate-risk prostate cancer (clinical stage T1b-2b, and Gleason Score (GS) ¼ 7 and prostate-specific antigen PSA level o15 ng ml À1 , or GS p6 and PSA between 10 and 20 ng ml À1 ) treated with ultrasound-based image-guided radiotherapy. Methods: VAT, SAT and WC (measured from planning abdominal computed tomography) and BMI were compared with clinical and pathologic factors using univariate analyses. Cox regression analyses were performed to evaluate whether obesity indices significantly predicted biochemical disease free-survival (bDFS). Results: Of the 112 eligible patients, 30 (27%) were obese. Median BMI at baseline was 27.5 kg m À2 (range, 19.2-51.5 kg m À2 ). Greater abdominal adiposity, WC and BMI were significantly associated with younger age at diagnosis and increased prostate volume (P ¼ 0.003 and P ¼ 0.002, respectively). No significant correlation between obesity measures and T-stage, GS, PSA or percentage of positive cores at biopsy was found. On Cox regression analyses, none of the obesity measures predicted for bDFS. No association was observed between obesity indices and surrogate markers of biochemical failure as PSA nadir (nPSA) or time to nPSA. Conclusions: Abdominal adiposity, WC and BMI are associated with younger age at diagnosis and greater prostate volume but not with an increased risk of biochemical failure in patients with intermediate-risk prostate cancer.

Abdominal and pelvic adipose tissue distribution and risk of prostate cancer recurrence after radiation therapy

“…However, the role of adipose tissue distribution in prostate cancer outcomes is less clear. One study of 112 eligible men treated with radiotherapy found that there was no association between obesity measures (visceral and subcutaneous adipose tissues, WC, or BMI) and biochemical failure 19 . Consistent with this study, we found no significant association between overall, visceral, subcutaneous or pelvic adiposity measures and risk of recurrence, prostate cancer‐specific mortality, or all‐cause mortality.…”

Racial Differences in Adipose Tissue Distribution and Risk of Aggressive Prostate Cancer among Men Undergoing Radiotherapy

“…VFA and SFA were calculated using the Eclipse ™ automatic area tool on a single CT slice at the level of L4/L5, as previously described [15] (Figure 1). Since waist circumference (WC) was not measured among these patients in clinic, we determined it retrospectively from the same CT slice as for VFA and SFA.…”

Growth and Progression of TRAMP Prostate Tumors in Relationship to Diet and Obesity

“…Obesity was reported to be associated with higher prostate cancer grade at diagnosis [12, 13], increased tumor volume at radical prostatectomy [14, 15] as well as with higher recurrence rates [16]. Abdominal adiposity, waist circumference and BMI were also associated with greater prostate volume as well as younger age at diagnosis [17]. In addition, mortality from prostate cancer has been reported to be increased with elevated body weights [18]; however, other studies have not found this [17].…”

“…Abdominal adiposity, waist circumference and BMI were also associated with greater prostate volume as well as younger age at diagnosis [17]. In addition, mortality from prostate cancer has been reported to be increased with elevated body weights [18]; however, other studies have not found this [17]. In an examination of a recent meta-analysis of prostate cancer as it related to obesity, it was found that a 5 kg/m 2 increase in BMI was associated with a 15–20% higher risk of dying of prostate cancer depending on what type of study was conducted and a 21% increased chance of biochemical relapse [19].…”