BMI in patients with localized prostate cancer may predict likelihood of receiving treatment, quality of life

Patients with localized prostate cancer (PCa) and a BMI of at least 33 kg/m2 or greater were less likely to receive surgery (RP) as treatment, according to results presented at Society of Urologic Oncology 22nd Annual Meeting.1

Nathan Samora—who presented the results and is a 4th year medical student at the 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 <0.001). 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 to 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; Virtual. November 30-December 3, 2021. Abstract 105.