title: Body mass index, prostate cancer-specific mortality, and biochemical recurrence: a systematic review and meta-analysis.
abstract: Increasing evidence suggested obesity, measured by body mass index (BMI), was associated with prostate cancer-specific mortality, and its impact on biochemical recurrence was also inconclusive. We systematically searched MEDLINE, EMBASE, and bibliographies of retrieved studies up to January 5, 2010. We used random-effects meta-analysis to assess the relative risks (RR) of prostate cancer-specific mortality and biochemical recurrence associated with a 5 kg/m(2) increase in BMI. Among the six population-based cohort studies in 1,263,483 initially cancer-free men, 6,817 prostate cancer deaths occurred; a 5 kg/m(2) increase in BMI was associated with 15% (RR: 1.15, 95% confidence interval (CI): 1.06-1.25, P < 0.01) higher risk of dying of prostate cancer. In the six postdiagnosis survival studies on 18,203 patients with 932 prostate cancer deaths, a 5 kg/m(2) increase in BMI was associated with 20% higher prostate cancer-specific mortality (RR: 1.20, 95% CI: 0.99-1.46, P = 0.06). In the sixteen studies which followed 26,479 prostate cancer patients after primary treatment, a 5 kg/m(2) increase in BMI was significantly associated with 21% increased risk of biochemical recurrence (RR: 1.21, 95% CI: 1.11-1.31 P < 0.01). Elevated BMI is associated with risk of prostate cancer-specific mortality in prospective cohort studies and biochemical recurrence in prostate cancer patients. Its association with prostate cancer-specific mortality in diagnosed patients needs to be further evaluated.
authors.affiliation: Channing Laboratory, Department of Medicine, Brigham and Women's Hospital, Boston, MA 02115, USA.
authors.forename: Yin
authors.initials: Y
authors.lastname: Cao
authors.forename: Jing
authors.initials: J
authors.lastname: Ma
mesh_terms: D015992:Body Mass Index; D006801:Humans; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000209:etiology / Q000401:mortality* / Q000473:pathology; D009765:Obesity / Q000150:complications*; D011471:Prostatic Neoplasms / Q000209:etiology / Q000401:mortality* / Q000473:pathology*; D012306:Risk