A Comparison of Surgical and Functional Outcomes in Prostate Cancer Patients with Overweight and Obesity Participating in a Presurgical Weight Loss Trial.

BACKGROUND/OBJECTIVES: Obesity and abdominal adiposity are associated with worse surgical and functional outcomes in prostate cancer (PCa) patients. This exploratory study assessed whether reductions in total body fat mass (TFM) among overweight and obese PCa patients enrolled in a diet and exercise weight loss intervention prior to robotic-assisted radical prostatectomy (RARP) improved outcomes.

METHODS

In this secondary analysis of an NIH-funded randomized controlled trial (NCT01886677) conducted 2012-2015, twenty-nine patients with newly diagnosed, pathology-confirmed PCa who participated and underwent RARP were evaluated for percent change in TFM and divided into High Fat Losers who lost ≥1% TFM per week and Low Fat Losers who lost <1% TFM per week. High versus Low Fat Losers were compared on operative time (OT), estimated blood loss (EBL), length of hospital stay (LOS), incidence of surgical or postoperative complications, and incontinence and impotence scores at first postoperative follow-up.

RESULTS

There was a statistically significant difference between High versus Low Fat Losers with respect to overall complications ( = 0.027); 28.6% of High Fat Losers experienced one or more complications by first postoperative follow-up, compared to 73.3% of Low Fat Losers. However, no differences were observed for each individual complication analyzed, or with respect to OT, EBL, LOS, or incontinence or impotence scores.

CONCLUSIONS AND RELEVANCE

Findings implicate the potential benefit of healthy weight loss as an adjunct to surgery, and support the need for larger trials to elucidate a clearer relationship between improvements in body composition and effects on specific surgical complications and functional outcomes.