van Roermund Joep G H, Kok Dieuwertje E G, Wildhagen Mark F, Kiemeney Lambertus A, Struik Femke, Sloot Sarah, van Oort Inge M, Hulsbergen-van de Kaa Christina A, van Leenders Geert J L H, Bangma Chris H, Witjes J Alfred
Department of Urology, University Medical Center Utrecht, The Netherlands.
BJU Int. 2009 Aug;104(3):321-5. doi: 10.1111/j.1464-410X.2009.08404.x. Epub 2009 Feb 11.
To investigate whether body mass index (BMI) is a prognostic factor for biochemical recurrence (BCR) in Dutch men after radical prostatectomy (RP), as although epidemiological studies of obesity in relation to prostate cancer have provided conflicting results, recent studies from the USA suggest that a higher BMI is a risk factor for progression of prostate cancer.
Of the 1417 patients with prostate cancer who had RP at two University hospitals, 1302 were included in the present study. BMI (kg/m(2)) classes were defined as normal (<25), overweight (25-30) and obese (> or =30). The median follow-up was 59 months and clinical data were obtained retrospectively from charts. BCR was defined as two consecutive prostate-specific antigen (PSA) levels of >0.1 ng/mL.
In all, 600 patients were classified as having normal weight (43.9%), 665 as overweight (48.6%) and 103 as obese (7.5%). Overall, 297 patients developed BCR after RP; the 10-year risk (95% confidence interval) of BCR was 31.9 (26.6-37.2)%, 30.5 (25.8-35.2)% and 23.9 (14.9-32.9)% for patients in the three categories, respectively (P = 0.836). Multivariable proportional hazard regression analyses of BMI and established prognostic factors for BCR did not change these results.
BMI appeared to have no prognostic value for BCR in Dutch patients with clinically localized prostate cancer and treated with RP.
探讨体重指数（BMI）是否为荷兰男性根治性前列腺切除术（RP）后生化复发（BCR）的预后因素。尽管关于肥胖与前列腺癌关系的流行病学研究结果相互矛盾，但美国最近的研究表明，较高的BMI是前列腺癌进展的危险因素。
在两家大学医院接受RP的1417例前列腺癌患者中，本研究纳入了1302例。BMI（kg/m²）类别定义为正常（<25）、超重（25 - 30）和肥胖（≥30）。中位随访时间为59个月，临床数据通过回顾病历获得。BCR定义为连续两次前列腺特异性抗原（PSA）水平>0.1 ng/mL。
总共600例患者体重正常（43.9%），665例超重（48.6%），103例肥胖（7.5%）。总体而言，297例患者RP后发生BCR；三类患者BCR的10年风险（95%置信区间）分别为31.9（26.6 - 37.2）%、30.5（25.8 - 35.2）%和23.9（14.9 - 32.9）%（P = 0.836）。对BMI及已确定的BCR预后因素进行多变量比例风险回归分析，结果未改变。
对于接受RP治疗的荷兰临床局限性前列腺癌患者，BMI似乎对BCR没有预后价值。
