Shiota Masaki, Takeuchi Ario, Sugimoto Masaaki, Kashiwagi Eiji, Dejima Takashi, Kiyoshima Keijiro, Inokuchi Junichi, Tatsugami Katsunori, Yokomizo Akira, Eto Masatoshi
Department of Urology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Ann Surg Oncol. 2017 May;24(5):1443-1450. doi: 10.1245/s10434-016-5705-2. Epub 2016 Nov 28.
This study aimed to examine the differential impact of body mass index and the feature of metabolic syndrome (MetS; obesity, hypertension, diabetes mellitus, and dyslipidemia) on biochemical recurrence (BCR) following radical prostatectomy (RP) treatment for prostate cancer using different surgical procedures.
This study included 283 Japanese patients with clinically localized prostate cancer who were treated with RP between 2008 and 2012. The prognostic significance of overweight and the feature of MetS were analyzed according to surgical procedures.
BCR occurred in 68/283 (24.0%) men. Overweight and the feature of MetS were predictors of BCR in patients who had undergone open RP (ORP), but not in those treated with laparoscopic surgery. Multivariate analyses incorporating preoperative and postoperative risk factors revealed that overweight and the feature of MetS were independent BCR risk factors when treated with ORP.
In Japanese men, overweight and the feature of MetS were associated with worse outcomes following RP, particularly ORP, compared with those following laparoscopic surgery. These results suggest that laparoscopic surgery can overcome the surgical challenges associated with abdominal obesity.
本研究旨在探讨体重指数和代谢综合征（MetS；肥胖、高血压、糖尿病和血脂异常）特征对采用不同手术方法治疗前列腺癌的根治性前列腺切除术（RP）后生化复发（BCR）的不同影响。
本研究纳入了2008年至2012年间接受RP治疗的283例日本临床局限性前列腺癌患者。根据手术方法分析超重和MetS特征的预后意义。
68/283（24.0%）名男性发生了BCR。超重和MetS特征是接受开放性RP（ORP）患者BCR的预测因素，但在接受腹腔镜手术的患者中并非如此。纳入术前和术后危险因素的多变量分析显示，接受ORP治疗时，超重和MetS特征是独立的BCR危险因素。
在日本男性中，与腹腔镜手术后相比，超重和MetS特征与RP后，尤其是ORP后的较差预后相关。这些结果表明，腹腔镜手术可以克服与腹部肥胖相关的手术挑战。
