title: Pathologic variables and recurrence rates as related to obesity and race in men with prostate cancer undergoing radical prostatectomy.
abstract: OBJECTIVE
  To determine if obesity is associated with higher prostate specific antigen recurrence rates after radical prostatectomy (RP), and to explore racial differences in body mass index (BMI) as a potential explanation for the disparity in outcome between black and white men.
  
  
  METHODS
  A retrospective, multi-institutional pooled analysis of 3,162 men undergoing RP was conducted at nine US military medical centers between 1987 and 2002. Patients were initially categorized as obese (BMI > or = 30 kg/m(2)), overweight (BMI 25 to 30 kg/m(2)), or normal (BMI < or = 25 kg/m(2)). For analysis, normal and overweight groups were combined (BMI < 30 kg/m(2)) and compared with the obese group (BMI > or = 30 kg/m(2)) with regard to biochemical recurrence (prostate-specific antigen > or = 0.2 ng/mL) after RP.
  
  
  RESULTS
  Of 3,162 patients, 600 (19.0%) were obese and 2,562 (81%) were not obese. BMI was an independent predictor of higher Gleason grade cancer (P <.001) and was associated with a higher risk of biochemical recurrence (P =.027). Blacks had higher BMI (P <.001) and higher recurrence rates (P =.003) than whites. Both BMI (P =.028) and black race (P =.002) predicted higher prostate specific antigen recurrence rates. In multivariate analysis of race, BMI, and pathologic factors, black race (P =.021) remained a significant independent predictor of recurrence.
  
  
  CONCLUSIONS
  Obesity is associated with higher grade cancer and higher recurrence rates after RP. Black men have higher recurrence rates and greater BMI than white men. These findings support the hypothesis that obesity is associated with progression of latent to clinically significant prostate cancer (PC) and suggest that BMI may account, in part, for the racial variability in PC risk.
authors.affiliation: Department of Urology, Naval Medical Center, 34800 Bob Wilson Drive, San Diego, CA 92134-5000, USA. clamling@nmcsd.med.navy.mil
authors.forename: Christopher L
authors.initials: CL
authors.lastname: Amling
authors.forename: Robert H
authors.initials: RH
authors.lastname: Riffenburgh
authors.forename: Leon
authors.initials: L
authors.lastname: Sun
authors.forename: Judd W
authors.initials: JW
authors.lastname: Moul
authors.forename: Raymond S
authors.initials: RS
authors.lastname: Lance
authors.forename: Leo
authors.initials: L
authors.lastname: Kusuda
authors.forename: Wade J
authors.initials: WJ
authors.lastname: Sexton
authors.forename: Douglas W
authors.initials: DW
authors.lastname: Soderdahl
authors.forename: Timothy F
authors.initials: TF
authors.lastname: Donahue
authors.forename: John P
authors.initials: JP
authors.lastname: Foley
authors.forename: Andrew K
authors.initials: AK
authors.lastname: Chung
authors.forename: David G
authors.initials: DG
authors.lastname: McLeod
mesh_terms: D044383:Black People; D015992:Body Mass Index; D006801:Humans; D008297:Male; D008889:Military Personnel; D009364:Neoplasm Recurrence, Local / Q000097:blood / Q000208:ethnology* / Q000209:etiology; D009367:Neoplasm Staging; D009765:Obesity / Q000150:complications / Q000208:ethnology*; D011379:Prognosis; D017430:Prostate-Specific Antigen / Q000097:blood; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000208:ethnology* / Q000209:etiology / Q000601:surgery; D012189:Retrospective Studies; D012307:Risk Factors; D014481:United States; D044465:White People; D001741:Black or African American
chemical_list: D017430:Prostate-Specific Antigen