Obesity adversely affects health related quality of life before and after radical retropubic prostatectomy.
OBJECTIVE
Obesity adversely affects surgical procedures and outcomes. We used a validated health related quality of life measure to examine the effects of obesity on disease specific health related quality of life before and following radical retropubic prostatectomy.


METHODS
From June 2000 to April 2003, 575 consecutive patients with prostate cancer were approached to participate in a prospective, health related quality of life study. Health related quality of life was assessed before surgery, and 1, 4, 12, 24 and 36 months postoperatively. Repeated measures mixed models were constructed to determine the independent effects of body mass index on health related quality of life.


RESULTS
Of 472 consenting subjects 376 (80%) completed a baseline and at least 1 followup survey. Higher body mass index was associated with worse preoperative hormonal/vitality function (p = 0.0009) and bother (p = 0.02), and delayed recovery of bowel function (p = 0.01) and bother (p = 0.01) health related quality of life. There were no measurable differences postoperatively in hormonal/vitality, urinary or sexual health related quality of life associated with higher body mass index. Increased body mass index was associated with prostate specific antigen recurrence (p = 0.05) and adjuvant treatment (p = 0.02). Adjuvant treatment was independently associated with worse bowel function (p = 0.01) and bother (p = 0.01) health related quality of life in obese patients. At 24 months bowel health related quality of life in obese patients no longer significantly differed from that in nonobese patients.


CONCLUSIONS
Obesity is associated with worse preoperative hormonal/vitality health related quality of life, slower recovery of bowel function and bother health related quality of life after radical retropubic prostatectomy, and prostate specific antigen recurrence. Impaired health related quality of life recovery in obese patients is influenced by disease recurrence and resultant adjuvant therapies. Despite these findings obese patients should not be dissuaded from considering prostatectomy as definitive treatment for localized prostate cancer.
Montgomery
Jeffrey S
JS
University of Michigan Urology Center, University Health System, 1500 East Medical Center Drive, Ann Arbor, MI 48109, USA.
Gayed
Bishoy A
BA
Hollenbeck
Brent K
BK
Daignault
Stephanie
S
Sanda
Martin G
MG
Montie
James E
JE
Wei
John T
JT
D015992:Body Mass Index; D017024:Chemotherapy, Adjuvant; D006304:Health Status; D006801:Humans; D007422:Intestines / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications; D011183:Postoperative Complications; D017430:Prostate-Specific Antigen / Q000097:blood; D011468:Prostatectomy / Q000009:adverse effects*; D011471:Prostatic Neoplasms / Q000097:blood / Q000150:complications / Q000601:surgery*; D011788:Quality of Life; D018714:Radiotherapy, Adjuvant; D011795:Surveys and Questionnaires
D017430:Prostate-Specific Antigen