Obese patients with castration-resistant prostate cancer may be at a lower risk of all-cause mortality: results from the Shared Equal Access Regional Cancer Hospital (SEARCH) database

被引:16
作者
Vidal, Adriana C. [1 ]
Howard, Lauren E. [2 ,3 ]
de Hoedt, Amanda [2 ]
Kane, Christopher J. [4 ]
Terris, Martha K. [5 ,6 ]
Aronson, William J. [7 ,8 ]
Cooperberg, Matthew R. [9 ]
Amling, Christopher L. [10 ]
Freedland, Stephen J. [1 ,2 ]
机构
[1] Cedars Sinai Med Ctr, Dept Surg, Div Urol, Los Angeles, CA 90048 USA
[2] VA Med Ctr, Urol Sect, Durham, NC USA
[3] Duke Univ, Dept Biostat & Bioinformat, Sch Med, Durham, NC USA
[4] Univ Calif San Diego Hlth Syst, Dept Urol, San Diego, CA USA
[5] VA Med Ctr Augusta, Urol Sect, Augusta, GA USA
[6] Med Coll Georgia, Urol Sect, Augusta, GA 30912 USA
[7] Vet Affairs VA Greater LosAngeles Healthcare Syst, Urol Sect, Dept Surg, Los Angeles, CA USA
[8] Univ Calif Los Angeles, Sch Med, Dept Urol, Los Angeles, CA USA
[9] Univ Calif San Francisco, Dept Urol, Helen Diller Family Comprehens Canc Ctr, San Francisco, CA USA
[10] Oregon Hlth & Sci Univ, Div Urol, Portland, OR USA
基金
美国国家卫生研究院;
关键词
obesity; castration-resistant prostate cancer; #PCSM; #ProstateCancer; BODY-MASS INDEX; RADICAL PROSTATECTOMY; PROSPECTIVE COHORT; SURVIVAL; MEN; OUTCOMES;
D O I
10.1111/bju.14193
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
ObjectiveTo assess whether obesity is associated with progression to metastasis, prostate cancer-specific mortality (PCSM), and all-cause mortality (ACM), in patients with non-metastatic castration-resistant prostate cancer (non-mCRPC). At the population level, obesity is associated with prostate cancer mortality; however, some studies have found that higher body mass index (BMI) is associated with better long-term prostate cancer outcomes amongst men with mCRPC. Patients and MethodsWe identified 1 192 patients with non-mCRPC from the Shared Equal Access Regional Cancer Hospital (SEARCH) database. BMI was calculated from height and weight abstracted from the medical records at the time closest to but prior to CRPC diagnosis and categorised as underweight (<21 kg/m(2)), normal weight (21-24.9 kg/m(2)), overweight (25-29.9 kg/m(2)), and obese (30 kg/m(2)). Competing risks regression and Cox models were used to test associations between obesity and progression to metastasis, PCSM, and ACM, accounting for confounders. ResultsOverall, 51 (4%) men were underweight, 239 (25%) were normal weight, 464 (39%) were overweight, and 438 (37%) were obese. In adjusted analysis, higher BMI was significantly associated with reduced ACM (hazard ratio [HR] 0.98, P = 0.012) but not PCSM (HR 1.00, P = 0.737) or metastases (HR 0.99, P = 0.225). Likewise, when BMI was treated as a categorical variable in adjusted models, obesity was not associated with PCSM (HR 1.11, P = 0.436) or metastases (HR 1.06, P = 0.647), but was associated with decreased ACM (HR 0.79, P = 0.016) compared to normal weight. No data were available on treatments received after CRPC diagnosis. ConclusionsAmongst patients with non-mCRPC obesity was associated with better overall survival. Although this result mirrors evidence from men with mCRPC, obesity was not associated with prostate cancer outcomes. Larger studies are needed to confirm these findings.
引用
收藏
页码:76 / 82
页数:7
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