Pfitzenmaier Jesco, Pritsch Maria, Haferkamp Axel, Jakobi Hildegard, Fritsch Frederik, Gilfrich Christian, Djakovic Nenad, Buse Stephan, Pahernik Sascha, Hohenfellner Markus
Department of Urology, Medical Centre, University of Heidelberg, Heidelberg, Germany.
BJU Int. 2009 Apr;103(7):877-82. doi: 10.1111/j.1464-410X.2008.08149.x. Epub 2008 Oct 24.
To evaluate the effect of body mass index (BMI) on the histopathological and clinical outcome in prostate cancer.
In a prospective urological cancer database, 620 patients with prostate cancer had a radical prostatectomy (RP) as a curative treatment. The patients were categorized into three groups of BMI (kg/m(2)); <or=25.0 (190, 'normal weight'), >25.0-30.0 (343, 'overweight') and >30.0 (87, 'obese'). We evaluated the histopathological features and the clinical follow-up after RP. The median (range) age of the men was 64.4 (41.1-80.1) years and the median follow-up 5.5 (0.1-15.1) years. The preoperative median prostate-specific antigen (PSA) levels for normal, overweight and obese patients were 9.0 (0.3-133.0), 8.9 (0.4-230.0) and 9.2 (0.5-194.0) ng/mL, respectively.
Serum PSA levels were no different among the three groups (P = 0.92). The normal, overweight and obese patients had organ-confined prostate cancer in 53.7%, 57.1% and 58.6%, respectively (P = 0.34) and had lymph node metastases in 7.9%, 7.6% and 4.6% (P = 0.58). Tumour grading was no different for the three groups (P = 0.25). The PSA recurrence-free, prostate cancer-specific and overall survival for the three BMI groups did not differ significantly (each P > 0.05).
The BMI cannot be shown to be a predictor of adverse prognosis either for histopathological features or for the clinical outcome, e.g. PSA-free, prostate cancer-specific and overall survival, in a mid-European study population after RP.
评估体重指数（BMI）对前列腺癌组织病理学及临床结局的影响。
在一个前瞻性泌尿系统癌症数据库中，620例前列腺癌患者接受了根治性前列腺切除术（RP）作为根治性治疗。患者按BMI（kg/m²）分为三组：≤25.0（190例，“正常体重”）、>25.0至30.0（343例，“超重”）和>30.0（87例，“肥胖”）。我们评估了RP后的组织病理学特征及临床随访情况。男性患者的中位（范围）年龄为64.4（41.1 - 80.1）岁，中位随访时间为5.5（0.1 - 15.1）年。正常、超重和肥胖患者术前前列腺特异性抗原（PSA）水平的中位数分别为9.0（0.3 - 133.0）、8.9（0.4 - 230.0）和9.2（0.5 - 194.0）ng/mL。
三组患者的血清PSA水平无差异（P = 0.92）。正常、超重和肥胖患者的器官局限性前列腺癌发生率分别为53.7%、57.1%和58.6%（P = 0.34），淋巴结转移率分别为7.9%、7.6%和4.6%（P = 0.58）。三组患者的肿瘤分级无差异（P = 0.25）。三个BMI组的无PSA复发、前列腺癌特异性及总生存率无显著差异（各P > 0.05）。
在欧洲中部的一项研究人群中，RP后BMI无论是对组织病理学特征还是对临床结局，如无PSA、前列腺癌特异性及总生存率，均不能显示为不良预后的预测指标。
