Department of Urology, Radboud University Nijmegen Medical Centre, PO Box 9101, 6500 HB Nijmegen, The Netherlands.
World J Urol. 2011 Oct;29(5):695-701. doi: 10.1007/s00345-010-0629-0. Epub 2010 Dec 16.
To determine the effect of body mass index (BMI) on clinical and pathological characteristics at time of diagnosis and on risk of biochemical recurrence after radical prostatectomy among Dutch men diagnosed with prostate cancer.
In total, 1,116 prostate cancer patients with known BMI, diagnosed between 2003 and 2006, were identified from the population-based cancer registry held by the Comprehensive Cancer Centre East, The Netherlands. Of these, 504 patients underwent a radical prostatectomy. Patients were categorized as normal weight (BMI < 25 kg/m(2)), overweight (BMI 25-30 kg/m(2)), or obese (BMI ≥ 30 kg/m(2)). Multivariable proportional hazards regression models, adjusted for age, prediagnostic PSA levels, and pathological characteristics were used to evaluate BMI as a prognostic factor for biochemical recurrence after radical prostatectomy.
Overall, clinical and biopsy characteristics did not significantly differ among BMI groups. Pathological characteristics after radical prostatectomy did not significantly differ among BMI groups, except for tumor stage, which was highest in obese patients (P = 0.017). For patients treated with radical prostatectomy, 5-year risk (95% Confidence Intervals) of biochemical recurrence was 30% (23-37%) for normal weight, 32% (25-39%) for overweight, and 25% (9-41%) for obese patients (log rank P = 0.810). BMI was not an independent prognostic factor for biochemical recurrence in multivariable proportional hazards regression analyses (HR 0.99 per kg/m(2), 95% CI: 0.93-1.06).
Compared with non-obese men, pathological tumor stage tended to be higher in obese men. Clinical relevance of this finding is unclear, because BMI was not an independent predictor of biochemical recurrence after radical prostatectomy.
确定体质指数（BMI）对荷兰男性前列腺癌患者诊断时临床和病理特征的影响，以及对根治性前列腺切除术后生化复发风险的影响。
从荷兰综合癌症中心东部的人群癌症登记处确定了 1116 名已知 BMI 的前列腺癌患者，这些患者于 2003 年至 2006 年间被诊断为前列腺癌。其中 504 名患者接受了根治性前列腺切除术。患者被分为正常体重（BMI<25kg/m²）、超重（BMI 25-30kg/m²）或肥胖（BMI≥30kg/m²）。多变量比例风险回归模型，调整年龄、诊断前 PSA 水平和病理特征，用于评估 BMI 作为根治性前列腺切除术后生化复发的预后因素。
总体而言，BMI 组之间的临床和活检特征没有显著差异。除肿瘤分期外，BMI 组之间的根治性前列腺切除术后病理特征没有显著差异，肥胖患者的肿瘤分期最高（P=0.017）。对于接受根治性前列腺切除术的患者，5 年生化复发风险（95%置信区间）分别为正常体重组 30%（23-37%）、超重组 32%（25-39%）和肥胖组 25%（9-41%）（对数秩检验 P=0.810）。BMI 不是多变量比例风险回归分析中生化复发的独立预后因素（每公斤/平方米增加 0.99，95%CI：0.93-1.06）。
与非肥胖男性相比，肥胖男性的肿瘤病理分期往往更高。由于 BMI 不是根治性前列腺切除术后生化复发的独立预测因素，因此该发现的临床意义尚不清楚。
