Obesity, race, and long-term prostate cancer outcomes

被引:34
|
作者
Vidal, Adriana C. [1 ]
Oyekunle, Taofik [2 ,3 ]
Howard, Lauren E. [2 ,3 ]
De Hoedt, Amanda M. [2 ]
Kane, Christopher J. [4 ]
Terris, Martha K. [5 ]
Cooperberg, Matthew R. [7 ]
Amling, Christopher L. [8 ]
Klaassen, Zachary [6 ]
Freedland, Stephen J. [1 ,2 ]
Aronson, William J. [9 ,10 ]
机构
[1] Cedars Sinai Med Ctr, Dept Surg, Div Urol, SSB Suite 191, Los Angeles, CA 90048 USA
[2] Vet Affairs Hlth Care Syst, Urol Sect, Durham, NC USA
[3] Duke Univ, Sch Med, Duke Canc Inst, Durham, NC USA
[4] Univ Calif San Diego Hlth Syst, Urol Dept, San Diego, CA USA
[5] Vet Affairs Hlth Care Syst, Sect Urol, Augusta, GA USA
[6] Med Coll Georgia, Sect Urol, Augusta, GA 30912 USA
[7] Univ Calif San Francisco, Helen Diller Family Comprehens Canc Ctr, Dept Urol, San Francisco, CA USA
[8] Oregon Hlth & Sci Univ, Div Urol, Portland, OR USA
[9] Vet Affairs Greater Los Angeles Healthcare Syst, Urol Sect, Dept Surg, Los Angeles, CA USA
[10] Univ Calif Los Angeles, Sch Med, Dept Urol, Los Angeles, CA USA
基金
美国国家卫生研究院;
关键词
obesity; outcomes; prostate cancer; race; radical prostatectomy; BODY-MASS INDEX; EQUAL ACCESS; RADICAL PROSTATECTOMY; RISK; MEN; SURVIVAL; ASSOCIATION; MORTALITY; FAILURE; DISEASE;
D O I
10.1002/cncr.32906
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Background The authors previously found that obesity was linked with prostate cancer (PC)-specific mortality (PCSM) among men who underwent radical prostatectomy (RP). Herein, in a larger RP cohort, the authors investigated whether the association between obesity and long-term PC outcomes, including PCSM, differed by race. Methods Data from 5929 patients who underwent RP and were in the Shared Equal Access Regional Cancer Hospital (SEARCH) database were analyzed. Prior to RP, body mass index (BMI) was measured and recorded in the medical records. BMI was categorized as normal weight (<25 kg/m(2)), overweight (25-29.9 kg/m(2)), and obese (>= 30 kg/m(2)). The authors assessed the association between BMI and biochemical disease recurrence (BCR), castration-resistant prostate cancer (CRPC), metastasis, and PCSM, accounting for confounders. Results Of the 5929 patients, 1983 (33%) were black, 1321 (22%) were of normal weight, 2605 (44%) were overweight, and 2003 (34%) were obese. Compared with white men, black men were younger; had higher prostate-specific antigen levels; and were more likely to have a BMI >= 30 kg/m(2), seminal vesicle invasion, and positive surgical margins (all P <= .032). During a median follow-up of 7.4 years, a total of 1891 patients (32%) developed BCR, 181 patients (3%) developed CRPC, 259 patients (4%) had metastasis, and 135 patients (2%) had died of PC. On multivariable analysis, obesity was found to be associated with an increased risk of PCSM (hazard ratio, 1.78; 95% confidence interval, 1.04-3.04 [P = .035]). No interaction was found between BMI and race in predicting PCSM (P >= .88), BCR (P >= .81), CRPC (P >= .88), or metastasis (P >= .60). Neither overweight nor obesity was associated with risk of BCR, CRPC, or metastasis (all P >= .18). Conclusions Obese men undergoing RP at several Veterans Affairs hospitals were found to be at an increased risk of PCSM, regardless of race.
引用
收藏
页码:3733 / 3741
页数:9
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