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Obesity, weight gain, and risk of biochemical failure among prostate cancer patients following prostatectomy.

Abstract

PURPOSE

Several lines of evidence suggest that diet and weight gain may be important environmental factors implicated in prostate carcinogenesis, especially in tumor progression. The purpose of this study was to evaluate obesity at different ages in a well-characterized cohort of prostate cancer patients treated with prostatectomy and to develop a prognostic model that incorporates body mass index (BMI) as a measure of obesity.

EXPERIMENTAL DESIGN

We carried out a prospective study of 526 patients registered at the M.D. Anderson Cancer Center from 1992 to 2001. Kaplan-Meier and Cox proportional hazard analyses were done.

RESULTS

During an average follow-up of 54 months, 97 (18%) post-prostatectomy patients experienced biochemical failure. Patients who were obese (BMI > or = 30 kg/m2) at diagnosis had a higher rate of biochemical failure than nonobese men (P = 0.07). Those obese at 40 years had an even greater rate of biochemical failure (P = 0.001). Higher BMI at diagnosis [hazard ratio (HR), 1.07; P = 0.01] and Gleason score = 7(4 + 3) and > or =8 (HR, 3.9; P = 0.03 and HR, 10.0; P < or = 0.001, respectively) remained significant independent predictors of biochemical failure in multivariate analysis. Men who gained weight at the greatest rate (>1.5 kg/y) between 25 years and diagnosis progressed significantly sooner (mean time, 17 months) than those who exhibited a slower weight gain (mean time, 39 months; P(trend) = 0.005). The inclusion of obesity to the clinical nomogram improved performance.

CONCLUSIONS

Our findings validate the importance for a role of obesity in prostate cancer progression and suggest a link to the biological basis of prostate cancer progression that can be therapeutically exploited.

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  • Authors+Show Affiliations

    ,

    Department of Epidemiology, The University of Texas M.D. Anderson Cancer Center, Houston, Texas 77030, USA. sstrom@mdnaderson.org

    , , , , , ,

    Source

    MeSH

    Adult
    Aged
    Body Mass Index
    Cohort Studies
    Disease Progression
    Humans
    Male
    Middle Aged
    Obesity
    Prognosis
    Proportional Hazards Models
    Prospective Studies
    Prostate-Specific Antigen
    Prostatic Neoplasms
    Recurrence
    Time Factors
    Weight Gain

    Pub Type(s)

    Journal Article
    Research Support, N.I.H., Extramural
    Research Support, U.S. Gov't, Non-P.H.S.
    Research Support, U.S. Gov't, P.H.S.

    Language

    eng

    PubMed ID

    16203779

    Citation

    Strom, Sara S., et al. "Obesity, Weight Gain, and Risk of Biochemical Failure Among Prostate Cancer Patients Following Prostatectomy." Clinical Cancer Research : an Official Journal of the American Association for Cancer Research, vol. 11, no. 19 Pt 1, 2005, pp. 6889-94.
    Strom SS, Wang X, Pettaway CA, et al. Obesity, weight gain, and risk of biochemical failure among prostate cancer patients following prostatectomy. Clin Cancer Res. 2005;11(19 Pt 1):6889-94.
    Strom, S. S., Wang, X., Pettaway, C. A., Logothetis, C. J., Yamamura, Y., Do, K. A., ... Troncoso, P. (2005). Obesity, weight gain, and risk of biochemical failure among prostate cancer patients following prostatectomy. Clinical Cancer Research : an Official Journal of the American Association for Cancer Research, 11(19 Pt 1), pp. 6889-94.
    Strom SS, et al. Obesity, Weight Gain, and Risk of Biochemical Failure Among Prostate Cancer Patients Following Prostatectomy. Clin Cancer Res. 2005 Oct 1;11(19 Pt 1):6889-94. PubMed PMID: 16203779.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Obesity, weight gain, and risk of biochemical failure among prostate cancer patients following prostatectomy. AU - Strom,Sara S, AU - Wang,Xuemei, AU - Pettaway,Curtis A, AU - Logothetis,Christopher J, AU - Yamamura,Yuko, AU - Do,Kim-Anh, AU - Babaian,Richard J, AU - Troncoso,Patricia, PY - 2005/10/6/pubmed PY - 2006/2/9/medline PY - 2005/10/6/entrez SP - 6889 EP - 94 JF - Clinical cancer research : an official journal of the American Association for Cancer Research JO - Clin. Cancer Res. VL - 11 IS - 19 Pt 1 N2 - PURPOSE: Several lines of evidence suggest that diet and weight gain may be important environmental factors implicated in prostate carcinogenesis, especially in tumor progression. The purpose of this study was to evaluate obesity at different ages in a well-characterized cohort of prostate cancer patients treated with prostatectomy and to develop a prognostic model that incorporates body mass index (BMI) as a measure of obesity. EXPERIMENTAL DESIGN: We carried out a prospective study of 526 patients registered at the M.D. Anderson Cancer Center from 1992 to 2001. Kaplan-Meier and Cox proportional hazard analyses were done. RESULTS: During an average follow-up of 54 months, 97 (18%) post-prostatectomy patients experienced biochemical failure. Patients who were obese (BMI > or = 30 kg/m2) at diagnosis had a higher rate of biochemical failure than nonobese men (P = 0.07). Those obese at 40 years had an even greater rate of biochemical failure (P = 0.001). Higher BMI at diagnosis [hazard ratio (HR), 1.07; P = 0.01] and Gleason score = 7(4 + 3) and > or =8 (HR, 3.9; P = 0.03 and HR, 10.0; P < or = 0.001, respectively) remained significant independent predictors of biochemical failure in multivariate analysis. Men who gained weight at the greatest rate (>1.5 kg/y) between 25 years and diagnosis progressed significantly sooner (mean time, 17 months) than those who exhibited a slower weight gain (mean time, 39 months; P(trend) = 0.005). The inclusion of obesity to the clinical nomogram improved performance. CONCLUSIONS: Our findings validate the importance for a role of obesity in prostate cancer progression and suggest a link to the biological basis of prostate cancer progression that can be therapeutically exploited. SN - 1078-0432 UR - https://www.unboundmedicine.com/medline/citation/16203779/full_citation L2 - http://clincancerres.aacrjournals.org/cgi/pmidlookup?view=long&amp;pmid=16203779 DB - PRIME DP - Unbound Medicine ER -