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01-07-2018 | Original Article

Obesity paradox in prostate cancer: increased body mass index was associated with decreased risk of metastases after surgery in 13,667 patients

Authors: Jonas Schiffmann, Pierre I. Karakiewicz, Michael Rink, L. Manka, Georg Salomon, Derya Tilki, Lars Budäus, Raisa Pompe, Sami-Ramzi Leyh-Bannurah, Alexander Haese, P. Hammerer, Hartwig Huland, Markus Graefen, Pierre Tennstedt

Published in: World Journal of Urology | Issue 7/2018

Abstract

Introduction

Obesity might negatively affect prostate cancer (PCa) outcomes. However, evidence according to the associations between obesity and metastases-free survival after radical prostatectomy (RP) is still inconsistent.

Methods

We relied on PCa patients treated with RP at the Martini-Klinik Prostate Cancer Center between 2004 and 2015. First, multivariable Cox regression analyses examined the impact of obesity on metastases after RP. Last, in a propensity score matched cohort, Kaplan–Meier analyses assessed metastases-free survival according to body mass index (kg/m²) (BMI) strata (≥ 30 vs. < 25).

Results

Of 13,667 individuals, 1990 (14.6%) men were obese (BMI ≥ 30). Median follow-up was 36.4 month (IQR 13.3–60.8). Obese patients were less likely to exhibit metastases after RP (HR 0.7, 95% CI 0.5–0.97, p = 0.03). Similarly, after propensity score adjustment, obesity was associated with increased metastases-free survival (log rank p = 0.001).

Conclusion

We recorded the obesity paradox phenomenon in PCa patients. In particular, high BMI (≥ 30) was associated with decreased risk of metastases after RP, despite an increased risk being anticipated. Whether statin use might have affected the results was not assessed. Further research is needed to unravel the controversially debated association between obesity and PCa.

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Title: Obesity paradox in prostate cancer: increased body mass index was associated with decreased risk of metastases after surgery in 13,667 patients
Authors: Jonas Schiffmann
Pierre I. Karakiewicz
Michael Rink
L. Manka
Georg Salomon
Derya Tilki
Lars Budäus
Raisa Pompe
Sami-Ramzi Leyh-Bannurah
Alexander Haese
P. Hammerer
Hartwig Huland
Markus Graefen
Pierre Tennstedt
Publication date: 01-07-2018
Publisher: Springer Berlin Heidelberg
Published in: World Journal of Urology / Issue 7/2018
Print ISSN: 0724-4983
Electronic ISSN: 1433-8726
DOI: https://doi.org/10.1007/s00345-018-2240-8

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Obesity paradox in prostate cancer: increased body mass index was associated with decreased risk of metastases after surgery in 13,667 patients

Abstract

Introduction

Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusion

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