전립선암 환자의 비만도가 임상병리학적 인자 및 생화학적 재발에 미치는 영향

Abstract

Purpose: It is controversial that obesity affects the outcome of surgical treatment for the patients with prostate cancer. We investigated clinicopathological impact of body-mass index (BMI) in the patients with prostate cancer who underwent radical prostatectomy.

Materials and Methods : From the 14 medical centers, 1,392 patients were evaluated. Mean preoperative serum prostate-specific antigen (sPSA) and BMI were 10.3ng/ml and 24.3kg/m2, respectively. The patients were classified into three groups by BMI: normal (BMI＜23kg/m2), overweight (23kg/m2≤BMI＜27.5kg/m2), and obese (BMI≥27.5kg/m2). We evaluated various clinicopathological factors, including preoperative sPSA, biopsy and pathological Gleason score, clinical and pathological T stage, and resection margin status, in the three BMI-groups. We also analyzed hazard ratio for biochemical failure according to BMI.

Results:The proportions of the normal, overweight, and obese patients were 33.7%, 52.9%, and 13.4%, respectively. BMI was significantly negative correlation with sPSA (R=0.057, p=0.033). Among the preoperative factors, only biopsy Gleason score were significantly higher in the overweight and obese group than normal group (p=0.027). Pathological outcomes after radical prostatectomy in overweight and obese group were not different from those in normal group. Biochemical recurrence rate was also not affected by obesity. Biopsy and pathological Gleason score, preoperative sPSA, pathological stage, margin status, and D’Amico risk groups were significant risk factors for biochemical recurrence in univariate analysis.

Conclusions : The obese patients with prostate cancer showed lower sPSA than normal. Obesity itself had not influence on the pre and postoperative clinicopathological factors of prostate cancer and biochemical failure after radical prostatectomy.