High BMI in Localized Prostate Cancer Associated With Decreased Likelihood of Undergoing Surgery

Researchers identified a linear decrease in the likelihood of surgery once patients with localized prostate cancer reached a BMI of 33 or greater.

Findings presented at the 22nd Annual Meeting of the Society of Urologic Oncology demonstrated that patients with localized prostate cancer (PCa) and a body mass index (BMI) equal to or greater than 33 kg/m2 were less likely to undergo surgery (RP) as a treatment modality.

Nathan Samora—who presented the results and is a fourth-year medical student at Vanderbilt University School of Medicine—and fellow researchers sought to study the association between BMI and treatment modality as well as patient-reported outcomes after therapy.

The researchers found that men who were younger, less-educated, Black or had more comorbidities were more likely to be obese (P <.001). Additionally, there was no significant difference in PCa risks across BMI groups.

Results demonstrated a linear increase in the likelihood of receiving an RP as the BMI increased from 18 to 28 and there was a linear decrease of receiving an RP thereafter. This became statistically significant at a BMI of greater than or equal to 33, Samora said. At no BMI was the likelihood of receiving active surveillance (AS) statistically significant.

Additionally, it was found that obese men have worse sexual function at baseline and all other time points throughout the 5 years; however, it was observed that trajectories between normal weight and overweight men are highly similar.

After adjusting for disease specifications between obese and non-obese men, it was found that there were not clinically important differences in patient-reported outcomes for men who underwent definitive treatment.

Results also demonstrated that men who were obese and on active surveillance had worse urinary incontinence compared with non-obese peers at 6 months and through the 5 years.

Patients (n = 2378) included were from the Comparative Effectiveness Analysis of Surgery and Radiation (CEASAR) Study and were mostly White (77%), with a median age of 64 years and a median BMI of 27 kg/m2. Patient-reported quality of life was measured at enrollment and 6, 12, 36, and 60 months using the 26-item Expanded Prostate Index Composite (EPIC-26).

Reference

1. Samora, N, Wallis, C, Tallman, J, et al. Association between BMI and localized prostate cancer treatment modality and patient-reported outcomes. Presented at: Society of Urologic Oncology 22nd Annual Meeting; November 30-December 3, 2021; Orlando, FL. Abstract 105.