Ohwaki Kazuhiro, Endo Fumiyasu, Hattori Kazunori
Department of Urology, St. Luke's International Hospital, 9-1 Akashi-cho, Chuo-ku, Tokyo 104-8560, Japan; Health Management Center, JCHO Tokyo Shinjuku Medical Center, 5-1 Tsukudo-cho, Shinjuku-ku, Tokyo 162-8543, Japan.
Department of Urology, St. Luke's International Hospital, 9-1 Akashi-cho, Chuo-ku, Tokyo 104-8560, Japan.
Eur J Cancer. 2015 Mar;51(5):604-9. doi: 10.1016/j.ejca.2015.01.003. Epub 2015 Jan 19.
The aim of this study was to determine whether abdominal obesity, including visceral adipose tissue (VAT) measured by computed tomography and blood pressure (BP) were associated with biochemical recurrence of prostate cancer after prostatectomy.
We investigated 283 patients who underwent radical prostatectomy for prostate cancer retrospectively. We obtained information on body mass index (BMI), waist circumference (WC), VAT, BP, antihypertensive drug use, pretreatment prostate-specific antigen levels, pathological Gleason scores and postoperative surgical margin status. Hypertension was defined as systolic BP (SBP)⩾130mmHg or diastolic BP⩾85mmHg.
Among 283 patients, 41 (14%) developed biochemical recurrence subsequently. We performed a Cox proportional hazard regression analysis to assess the association of each obesity measurement and SBP with biochemical recurrence using clinical predictors as potential confounders. No association was observed between any obesity measurement assessed and biochemical recurrence. Adjusting for each of BMI, WC and VAT, a higher SBP was associated significantly with biochemical recurrence (hazard ratio [HR], adjusted for VAT=1.04; 95% confidence interval [CI]=1.02-1.07). Adjusting for obesity (BMI⩾25kg/m(2)), hypertension was also associated significantly with biochemical recurrence (HR=2.08; 95% CI=1.09-3.97). Compared with normotensive patients, those with untreated and uncontrolled hypertension had a significantly increased risk of biochemical recurrence (HR=2.45; 95% CI=1.06-5.66).
A higher BP and untreated, uncontrolled hypertension were independent risk factors for biochemical recurrence after prostatectomy. Control of hypertension could be an important treatment strategy for preventing biochemical recurrence.
本研究旨在确定腹部肥胖（包括通过计算机断层扫描测量的内脏脂肪组织[VAT]）和血压（BP）是否与前列腺切除术后前列腺癌的生化复发相关。
我们回顾性研究了283例行前列腺癌根治术的患者。我们获取了有关体重指数（BMI）、腰围（WC）、VAT、BP、抗高血压药物使用情况、术前前列腺特异性抗原水平、病理Gleason评分和术后手术切缘状态的信息。高血压定义为收缩压（SBP）⩾130mmHg或舒张压⩾85mmHg。
在283例患者中，41例（14%）随后发生了生化复发。我们进行了Cox比例风险回归分析，以评估每种肥胖测量指标和收缩压与生化复发之间的关联，并将临床预测因素作为潜在混杂因素。在所评估的任何肥胖测量指标与生化复发之间均未观察到关联。在调整BMI、WC和VAT后，较高的收缩压与生化复发显著相关（风险比[HR]，经VAT调整后=1.04；95%置信区间[CI]=1.02-1.07）。在调整肥胖因素（BMI⩾25kg/m²）后，高血压也与生化复发显著相关（HR=2.08；95%CI=1.09-3.97）。与血压正常的患者相比，未治疗和未控制高血压的患者生化复发风险显著增加（HR=2.45；95%CI=1.06-5.66）。
较高的血压以及未治疗、未控制的高血压是前列腺切除术后生化复发的独立危险因素。控制高血压可能是预防生化复发的重要治疗策略。
