Obesity does not predispose to more aggressive prostate cancer either at biopsy or radical prostatectomy in European men

Andrea Gallina, Pierre I. Karakiewicz, Georg C. Hutterer, Felix K H Chun, Alberto Briganti, Jochen Walz, Elie Antebi, Shahrokh F. Shariat, Nazareno Suardi, Markus Graefen, Andreas Erbersdobler, Andrea Salonia, Patrizio Rigatti, Hartwig Huland, Francesco Montorsi

Research output: Contribution to journalArticlepeer-review

Abstract

Many investigators suggested that obesity predisposes to adverse prostate cancer characteristics and outcomes. We tested the effect of obesity on the rate of aggressive prostate cancer at either prostate biopsy or radical prostatectomy (RP). Clinical and pathological data were available for 1,814 men. Univariable and multivariable logistic regression models addressed the rate of high grade prostate cancer (HGPCa) at either biopsy or final pathology. Clinical stage, prostate-specific antigen (PSA), percentage of free PSA and prostate volume were the base predictors. All models were fitted with and without body mass index (BMI), which quantified obesity. BMI and its reciprocal (InvBMI) were coded as cubic splines to allow nonlinear effects. Predictive accuracy (PA) was quantified with area under curve estimates, which were subjected to 200 bootstrap resamples to reduce overfit bias. Gains in PA related to the inclusion of BMI were compared using the Mantel-Haenszel test. HGPCa at biopsy was detected in 562 (31%) and HGPCa at RP pathology was present in 931 (51.3%) men. In either univariable or multivariable models predicting HGPCa at biopsy, BMI or InvBMI failed to respectively reach statistical significance or add to multivariable PA (BMI gain = 0%, p = 1.0; InvBMI gain = -0.2%, p = 0.9). Conversely, in models predicting HGPCa at RP, BMI and InvBMI represented independent predictors but failed to increase PA (BMI gain = 0.7%, p = 0.6; InvBMI gain = 0.5, p = 0.7%). Obesity does not predispose to more aggressive prostate cancer at biopsy. Similarly, obesity does not change the ability to identify those who may harbor HGPCa at RP.

Original languageEnglish
Pages (from-to)791-795
Number of pages5
JournalInternational Journal of Cancer
Volume121
Issue number4
DOIs
Publication statusPublished - Aug 15 2007

Keywords

  • Body mass index
  • High grade prostate cancer
  • Predictive accuracy

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

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