PSA recurrence predicted by excess body weight

Chicago-Excess body weight correlated with a significantly higher 5-year risk of biochemical recurrence after surgery for clinically localized prostate cancer, according to a study reported at the American Association for Cancer Research annual meeting in Chicago.

Each quartile increase in body mass index significantly increased the odds of PSA relapse, as defined by D'Amico risk criteria. The odds ratio for an intermediate- or high-risk D'Amico score spiraled upward to as much as 7.74 for the heaviest men compared with normal-weight patients.

The findings add to the volume of evidence implicating excess weight or obesity in prostate cancer development or progression.

"Whether some weight management intervention before or after treatment would be beneficial remains to be seen," he added. "At a minimum, the results suggest this is a group of patients to whom you want to pay special attention because they are at increased risk of recurrence within 5 years."

Obesity is associated with an increased risk of prostate cancer recurrence after definitive therapy (surgery or radiation therapy), as determined by post-treatment tumor histology or PSA kinetics. Excess weight activates several major pathways related to tumor development or progression, suggesting a possible mechanistic link.

Whether body weight correlates with pretreatment risk factors for recurrence had not been examined. To evaluate the issue, Dr. Freeman and colleagues studied 119 men with clinical diagnoses of localized prostate cancer, all of whom were scheduled for surgery.

Investigators determined the patients' pretreatment body-weight status by means of dual-energy x-ray absorptiometry and BMI. They compared the results with the men's D'Amico risk scores, derived from tumor stage, Gleason sum, and pretreatment PSA values. Each patient's risk of biochemical recurrence within 5 years was rated as low, intermediate, or high.