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- Title
Increased Body Mass Index Is a Risk Factor for Poor Clinical Outcomes after Radical Prostatectomy in Men with International Society of Urological Pathology Grade Group 1 Prostate Cancer Diagnosed with Systematic Biopsies.
- Authors
Ferro, Matteo; Terracciano, Daniela; Musi, Gennaro; de Cobelli, Ottavio; Vartolomei, Mihai Dorin; Damiano, Rocco; Cantiello, Francesco; Buonerba, Carlo; Morelli, Michele; Mistretta, Francesco Alessandro; Luzzago, Stefano; Perdonà, Sisto; Del Prete, Paola; Del Giudice, Francesco; Busetto, Gian Maria; Porreca, Angelo; Autorino, Riccardo; Manfredi, Matteo; Porpiglia, Francesco; Muto, Matteo
- Abstract
Introduction: The association between obesity and clinically significant prostate cancer (PCa) is still a matter of debate. In this study, we evaluated the effect of body mass index (BMI) on the prediction of pathological unfavorable disease (UD), positive surgical margins (PSMs), and biochemical recurrence (BCR) in patients with clinically localized (≤cT2c) International Society of Urological Pathology (ISUP) grade group 1 PCa at biopsy. Methods: 427 patients with ISUP grade group 1 PCa who have undergone radical prostatectomy and BMI evaluation were included. The outcome of interest was the presence of UD (defined as ISUP grade group ≥3 and pT ≥3a), PSM, and BCR. Results: Statistically significant differences resulted in comparing BMI with prostate-specific antigen (PSA) and serum testosterone levels (both p < 0.0001). Patients with UD and PSM had higher BMI values (p < 0.0001 and p = 0.006, respectively). BCR-free survival was significantly decreased in patients with higher BMI values (p < 0.0001). BMI was an independent risk factor for BCR and PSM. Receiver-operating characteristic analysis testing PSA accuracy in different BMI groups, showed that PSA had a reduced predictive value (area under the curve [AUC] = 0.535; 95% confidence interval [CI] = 0.422–0.646), in obese men compared to overweight (AUC = 0.664; 95% CI = 0.598–0.725) and normal weight patients (AUC = 0.721; 95% CI = 0.660–0.777). Conclusion: Our findings show that increased BMI is a significant predictor of UD and PSM at RP in patients with preoperative low-to intermediate-risk diseases, suggesting that BMI evaluation may be useful in a clinical setting to identify patients with favorable preoperative disease characteristics harboring high-risk PCa.
- Subjects
PROSTATE cancer; BODY mass index; RADICAL prostatectomy; SURGICAL margin; CANCER diagnosis; PROSTATE-specific antigen
- Publication
Urologia Internationalis, 2022, Vol 106, Issue 1, p75
- ISSN
0042-1138
- Publication type
Article
- DOI
10.1159/000516680