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The relationship of body mass index and serum testosterone with disease outcomes in men with castration-resistant metastatic prostate cancer

Prostate Cancer and Prostatic Diseases volume 12, pages 88–93 (2009)Cite this article

Abstract

The purpose of this study was to evaluate the relationship of baseline body mass index (BMI) and serum testosterone level with prostate cancer outcomes in men with castration-resistant metastatic prostate cancer (CRPC). BMI and testosterone levels were evaluated for their ability to predict overall survival (OS) and prostate-specific antigen (PSA) declines in the TAX327 clinical trial, an international phase III randomized trial of one of the two schedules of docetaxel and prednisone compared with mitoxantrone and prednisone. In this study of 1006 men with CRPC, the median serum testosterone level was 14.5 ng per 100 ml (range 0–270), the median BMI was 27 kg m−2 (range 15.7–46.5), and 26% of men were obese or morbidly obese (BMI⩾30). Obesity was associated with younger age, lower PSA and alkaline phosphatase levels, and higher performance status, primary Gleason sum, testosterone and hemoglobin compared to absence of obesity. In multivariate analysis, neither BMI, presence of obesity, nor baseline testosterone was significantly associated with OS or PSA declines. Higher testosterone levels among obese men suggest incomplete gonadal suppression with current therapies, but these differences may not be clinically relevant in men with CRPC. There was evidence of potential hemodilution of PSA and alkaline phosphatase levels in obese men.

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Acknowledgements

We thank the many patients who volunteered to participate in the TAX327 study and the investigators who recruited them and managed their care, listed below.

MA Rosenthal from Australia; D Campos (Argentina); H Gurney and M Stockler (Australia); M Rauchenwald (Austria); T Gil, Y Humblet and A van Oosterom (Belgium); D Herchenhorn (Brazil); S Ernst, L Lacombe, M Moore, F Saad, D Soulieres, P Venner and E Winquist (Canada); M Urban (Czech Republic); P Kellokumpu-Lehtinen (Finland); G Deplanque, B Duclos, I Krakowski and L Mignot, S Oudard and C Theodore (France); J Breul and R Paul (Germany); I Bodrogi (Hungary); S Bracarda (Italy); G Chahine (Lebanon); JL Bruins and JA Witjes (the Netherlands); T Demkow and K Bar (Poland); O Kariakine and M Matveev (Russia); I Andrasina (Slovak Republic); D Vorobiof (South Africa); J Bellmunt and J-R Germa (Spain); I Turesson and A Widmark (Sweden); A Horwich, T Roberts, ND James and J Wylie (United Kingdom); and L Baez, W Dugan and N Tirumali (United States).

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Authors and Affiliations

  1. Duke Comprehensive Cancer Center, and the Duke Prostate Center, Duke University, Durham, NC, USA

    A J Armstrong

  2. Division of Medical Oncology, Department of Medicine, Duke Comprehensive Cancer Center, Duke University, Durham, NC, USA

    A J Armstrong

  3. Division of Medical Oncology, Department of Medicine, Duke Prostate Center, Duke University, Durham, NC, USA

    A J Armstrong

  4. Division of Urology, Department of Surgery, Duke Comprehensive Cancer Center, Duke University, Durham, NC, USA

    A J Armstrong & S Halabi

  5. Division of Urology, Department of Surgery, Duke Prostate Center, Duke University, Durham, NC, USA

    A J Armstrong

  6. Department of Biostatistics and Bioinformatics, Duke University, Durham, NC, USA

    S Halabi

  7. Department of Medical Oncology, Rotterdam Cancer Institute, Erasmus University Medical Center, Rotterdam, The Netherlands

    R de Wit

  8. Department of Medical Oncology, Princess Margaret Hospital, University of Toronto, Toronto, Ontario, Canada

    I F Tannock

  9. Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins Medical Institutions, Baltimore, MD, USA

    M Eisenberger

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  1. A J Armstrong
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  2. S Halabi
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  3. R de Wit
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  4. I F Tannock
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  5. M Eisenberger
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Corresponding author

Correspondence to A J Armstrong.

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Armstrong, A., Halabi, S., de Wit, R. et al. The relationship of body mass index and serum testosterone with disease outcomes in men with castration-resistant metastatic prostate cancer. Prostate Cancer Prostatic Dis 12, 88–93 (2009). https://doi.org/10.1038/pcan.2008.36

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  • DOI: https://doi.org/10.1038/pcan.2008.36

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