title: Influence of obesity on tumour volume in patients with prostate cancer.
abstract: OBJECTIVE
  • To investigate the association between body mass index and tumour volume at radical prostatectomy in a large European population.
  
  
  METHODS
  • Recent data support the hypothesis that the hormonal environment in overweight and obese men may alter androgen-dependent prostate growth. Body mass index (BMI) has been implicated in prostate cancer pathophysiology. • We analysed 1275 patients with prostate cancer who underwent radical prostatectomy at a single tertiary care institution. Mean tumour volume (TV) was evaluated according to BMI WHO categories (normal <25 kg/m(2) vs overweight 25-30 kg/m(2) vs obese 30-35 kg/m(2) vs severely obese >35 kg/m(2)). • Univariable linear regression analyses targeted the association between BMI and TV at radical prostatectomy. Multivariable analyses were adjusted for age, prostate-specific antigen value, biopsy Gleason sum, clinical stage and prostate volume.
  
  
  RESULTS
  • Mean BMI was 26.3 kg/m(2) (median 26; range 16.7-42.0). Mean TV was 5.6 mL (median 3.3; range 0.1-61.2). The mean prostate-specific antigen value was 10.3 ng/dL (median 6.6; range 0.3-327). • The mean TV was 5.0, 5.8, 6.3 and 9.2 mL in normal, overweight, obese and severely obese patients, respectively (P= 0.03). TVs in men with a normal BMI were 84% smaller than in severely obese men (5.0 vs 9.2 mL). • On univariable analysis, BMI was correlated with TV at radical prostatectomy (P < 0.001). On multivariable analysis, BMI reached the independent predictor status after adjustment for age, prostate-specific antigen value, biopsy Gleason score, clinical stage and prostate volume (P= 0.03).
  
  
  CONCLUSIONS
  • We showed that BMI is independently associated with prostate cancer volume at radical prostatectomy. The present results confirm that obesity may play a key role in prostate cancer pathophysiology.
authors.affiliation: Department of Urology, University Vita-Salute, San Raffaele Hospital, Milan, Italy. capitanio.umberto@hsr.it
authors.forename: Umberto
authors.initials: U
authors.lastname: Capitanio
authors.forename: Nazareno
authors.initials: N
authors.lastname: Suardi
authors.forename: Alberto
authors.initials: A
authors.lastname: Briganti
authors.forename: Andrea
authors.initials: A
authors.lastname: Gallina
authors.forename: Firas
authors.initials: F
authors.lastname: Abdollah
authors.forename: Giovanni
authors.initials: G
authors.lastname: Lughezzani
authors.forename: Andrea
authors.initials: A
authors.lastname: Salonia
authors.forename: Massimo
authors.initials: M
authors.lastname: Freschi
authors.forename: Francesco
authors.initials: F
authors.lastname: Montorsi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications*; D011471:Prostatic Neoplasms / Q000150:complications* / Q000473:pathology*; D047368:Tumor Burden