Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institute of Health, Bethesda, Maryland, United States of America.
PLoS One. 2011 Feb 24;6(2):e17382. doi: 10.1371/journal.pone.0017382.
Nomograms are tools used in clinical practice to predict cancer outcomes and to help make decisions regarding management of disease. Since its conception, utility of the prostate cancer nomogram has more than tripled. Limited information is available on the relation between the nomograms' predicted probabilities and obesity. The purpose of this study was to examine whether the predictions from a validated postoperative prostate cancer nomogram were associated with obesity.
We carried out a cross-sectional analysis of 1220 patients who underwent radical prostatectomy (RP) in southern California from 2000 to 2008. Progression-free probabilities (PFPs) were ascertained from the 10-year Kattan postoperative nomogram. Multivariable logistic regression models estimated odds ratios (ORs) and 95% confidence intervals (CIs).
In the present study, aggressive prostate cancer (Gleason ≥7), but not advanced stage, was associated with obesity (p = 0.01). After adjusting for age, black race, family history of prostate cancer and current smoking, an inverse association was observed for 10-year progression-free predictions (OR = 0.50; 95% CI = 0.28-0.90) and positive associations were observed for preoperative PSA levels (OR = 1.23; 95% CI = 1.01-1.50) and Gleason >7 (OR = 1.45; 95% CI = 1.11-1.90).
Obese RP patients were more likely to have lower PFP values than non-obese patients, suggesting a higher risk of experiencing prostate cancer progression. Identifying men with potentially higher risks due to obesity may improve disease prognosis and treatment decision-making.
列线图是用于预测癌症结局并帮助制定疾病管理决策的临床实践工具。自其诞生以来，前列腺癌列线图的实用性已经增加了两倍多。关于列线图预测概率与肥胖之间的关系，相关信息有限。本研究的目的是检验验证后的前列腺癌术后列线图的预测值是否与肥胖相关。
我们对 2000 年至 2008 年在加利福尼亚州南部接受根治性前列腺切除术（RP）的 1220 名患者进行了横断面分析。通过 10 年 Kattan 术后列线图确定无进展概率（PFP）。多变量逻辑回归模型估计了比值比（OR）和 95%置信区间（CI）。
在本研究中，侵袭性前列腺癌（Gleason≥7）而非晚期与肥胖有关（p=0.01）。在校正年龄、黑种人、前列腺癌家族史和当前吸烟状况后，观察到 10 年无进展预测的反比关系（OR=0.50；95%CI=0.28-0.90），而术前 PSA 水平（OR=1.23；95%CI=1.01-1.50）和 Gleason>7（OR=1.45；95%CI=1.11-1.90）与正相关。
与非肥胖患者相比，肥胖 RP 患者的 PFP 值更有可能较低，这表明他们更有可能经历前列腺癌进展。由于肥胖而识别出具有潜在更高风险的男性，可能会改善疾病预后和治疗决策。
