There has been a lot of controversy over the association between obesity and the eventual biochemical failure of men treated for prostate cancer.
Research performed at the Cleveland Clinic, Lerner College of Medicine of Case Western Reserve University, Cleveland, Ohio attempted to determined whether there is an association between body mass index and biochemical failure in men treated for low and intermediate risk prostate cancer with various treatment modalities.
A cohort study of 2,687 men who underwent treatment for low and intermediate risk prostate adenocarcinoma as described by National Comprehensive Cancer Network guidelines at Cleveland Clinic between January 1996 and December 2005 was performed. Univariate and multivariate analyses were done to determine the effect of multiple patient characteristics on biochemical failure.
- The study showed:
1- 319 men experienced a biochemical failures (11.9%).
2- Body mass index as a continuous variable was significantly associated with biochemical failure on univariate analysis (HR 1.030, p = 0.02). There was a significant association with biochemical failure when comparing normal vs overweight and normal vs obese men but not overweight vs obese men.
3- On multivariate analysis body mass index as a continuous or a categorical variable was not significantly associated with biochemical failure. Multivariate analysis revealed certain variables significantly associated with biochemical failure, including black race, greater initial prostate specific antigen, Gleason score 7, treatment type and more frequent prostate specific antigen screening.
The study concluded:
- 1- There was a significant association between body mass index and biochemical failure on univariate analysis that did not hold true on multivariate analysis.
2- However, being a black man was associated with biochemical failure on a multivariate analysis. The reason for this is unclear. Future studies should further characterize the relationship between race and biochemical failure.
Reference: J Urol. 2010 Apr 15. Epub ahead of print.
doi: 10.1016/j.juro.2010.02.010; Ly D, Reddy CA, Klein EA, Ciezki JP.
Joel T Nowak, M.A., M.S.W.