Department of Urology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania 15232, USA.
J Urol. 2009 Jul;182(1):112-7; discussion 117. doi: 10.1016/j.juro.2009.02.118. Epub 2009 May 17.
We examined the impact of obesity on disease specific and overall survival in patients with prostate cancer.
We identified 7,274 men from the Cancer of the Prostate Strategic Urological Research Endeavor database with clinically localized prostate cancer, known body mass index and clinicopathological disease characteristics. Patients were classified by body mass index as normal (less than 25 kg/m(2)), overweight (25 to 29.9 kg/m(2)), obese (30 to 34.9 kg/m(2)) and severely obese (35 kg/m(2) or greater). Associations between body mass index and need for secondary treatment, disease specific survival and overall survival were analyzed using univariate and multivariate models.
Patients were classified by body mass index category as normal (28.8%), overweight (50%), obese (16.4%) and very obese (4.8%). Mean followup was 51.3 +/- 38.5 months. During followup there were 1,044 deaths with 220 (21.1%) from prostate cancer. Stratified by body mass index category the groups differed with regard to the need for secondary treatment (p = 0.05) and overall mortality (p <0.01) but there were no significant differences with regard to disease specific survival (p = 0.09). On multivariate analysis age 65 to 74 years (HR 2.4, p = 0.002), age older than 75 years (HR 3.2, p = 0.0001), high risk disease (HR 1.6, p <0.0001), conservative treatment (HR 1.2, p <0.0001) and presence of diabetes (HR 1.6, p <0.0001) were associated with decreased overall survival. Only conservative treatment (HR 1.4, p <0.0001), high risk disease (HR 8.4, p <0.0001) and intermediate risk disease (HR 2.5, p = 0.004) were associated with decreased disease specific survival.
In a prospective, community based cohort we were unable to establish a relationship between body mass index and prostate cancer disease specific survival or overall survival.
我们研究了肥胖对患有前列腺癌患者的疾病特异性和总体生存率的影响。
我们从癌症前列腺战略泌尿研究 Endeavor 数据库中确定了 7274 名患有局限性前列腺癌、已知体重指数和临床病理疾病特征的男性患者。患者按体重指数分为正常（<25kg/m2）、超重（25-29.9kg/m2）、肥胖（30-34.9kg/m2）和严重肥胖（≥35kg/m2）。使用单变量和多变量模型分析体重指数与需要二次治疗、疾病特异性生存率和总体生存率之间的关系。
患者按体重指数类别分类为正常（28.8%）、超重（50%）、肥胖（16.4%）和非常肥胖（4.8%）。平均随访时间为 51.3+/-38.5 个月。随访期间有 1044 例死亡，其中 220 例（21.1%）死于前列腺癌。按体重指数类别分层，各组在需要二次治疗方面存在差异（p=0.05）和总体死亡率（p<0.01），但在疾病特异性生存率方面无显著差异（p=0.09）。多变量分析显示，65-74 岁年龄组（HR2.4，p=0.002）、75 岁以上年龄组（HR3.2，p=0.0001）、高危疾病（HR1.6，p<0.0001）、保守治疗（HR1.2，p<0.0001）和糖尿病（HR1.6，p<0.0001）与总体生存率降低相关。只有保守治疗（HR1.4，p<0.0001）、高危疾病（HR8.4，p<0.0001）和中危疾病（HR2.5，p=0.004）与疾病特异性生存率降低相关。
在一项前瞻性、基于社区的队列研究中，我们未能确定体重指数与前列腺癌疾病特异性生存率或总体生存率之间的关系。
