title: Obesity has multifaceted impact on biochemical recurrence of prostate cancer: a dose-response meta-analysis of 36,927 patients.
abstract: Obesity is inconsistently related to biochemical recurrence (BCR) of prostate cancer (PCa) in different epidemiological studies. We conducted a systematic review and dose-response meta-analysis of published studies from MEDLINE and EMBASE in order to determine the relationship between body mass index (BMI) and BCR of PCa. We identified a total of 26 studies including 36,927 individuals. Pooled estimates of relative risk (RR) and confidence interval (CI) were computed, and dose-response meta-analysis was subsequently performed. Based on the random-effects approach, a 5 kg/m(2) increase in BMI was associated with 16 % (RR 1.16, 95 % CI 1.08-1.24) higher risk of BCR for entire set of 26 studies. Significantly higher rates of BCR were also observed in radical prostatectomy series (RR 1.17, 95 % CI 1.07-1.28) and external beam radiation therapy series (RR 1.19, 95 % CI 1.10-1.28), while no significant correlation was observed in brachytherapy series (RR 0.91, 95 % CI 0.64-1.28). Different BCR outcomes came out for studies held in USA (RR 1.18, 95 % CI 1.10-1.28), Europe (RR 1.04 95 % CI 0.91-1.17) and Asia (RR 1.83 95 % CI 0.85-3.97), respectively. There was limited evidence of a nonlinear association between BMI and BCR, which showed a critical point of 33 in BMI. The findings from meta-analysis showed that excess BMI was positively correlated with BCR of PCa multifacetedly, indicating good weight control and detailed attention to treating obese patients might improve the prognosis of PCa.
authors.affiliation: Department of Urology, Huashan Hospital, Fudan University, No.12 Wulumuqi Road, Shanghai, 200040, China.
authors.forename: Meng-Bo
authors.initials: MB
authors.lastname: Hu
authors.forename: Hua
authors.initials: H
authors.lastname: Xu
authors.forename: Pei-De
authors.initials: PD
authors.lastname: Bai
authors.forename: Hao-Wen
authors.initials: HW
authors.lastname: Jiang
authors.forename: Qiang
authors.initials: Q
authors.lastname: Ding
mesh_terms: D006801:Humans; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis / Q000209:etiology*; D009765:Obesity / Q000503:physiopathology*; D011379:Prognosis; D011471:Prostatic Neoplasms / Q000150:complications* / Q000473:pathology*; D012196:Review Literature as Topic