Nonalcoholic fatty liver disease is a negative risk factor for prostate cancer recurrence.
Nonalcoholic fatty liver disease (NAFLD) is closely related to the metabolic syndrome, which is associated with an increased risk of various malignancies. In this study, we investigated the association between NAFLD and prostate cancer biochemical recurrence (BCR) after radical prostatectomy. Consecutive prostate cancer patients who underwent radical prostatectomy were enrolled from two hospitals in Korea and randomly assigned to the training (n=147) or validation set (n=146). The presence of NAFLD, BMI, preoperative prostate-specific antigen, and histological findings including Gleason score (GSc) were analyzed in regard to their association with BCR. NAFLD was diagnosed based on ultrasonography or unenhanced computed tomography images. BCR-free survival rates were calculated using the Kaplan-Meier method. In the training set, 32 (21.8%) patients developed BCR during a median follow-up period of 51 (inter-quartile range, 35-65) months. In the multivariate analysis, the presence of NAFLD (hazard ratio (HR), 0.36; 95% CI, 0.14-0.97; P=0.04) was an independent negative predictive factor of BCR after adjustment for pathological GSc. Applied to the validation set, the presence of NAFLD maintained its prognostic value for longer time-to-BCR (HR, 0.17; 95% CI, 0.06-0.49; P=0.001). In the subgroup analysis of patients with NAFLD, NAFLD fibrosis score was a single independent negative predictor for BCR (HR, 0.54; 95% CI, 0.30-0.98; P=0.04). Our study demonstrated that NAFLD may play a protective role against BCR after radical prostatectomy for prostate cancer. Further study is warranted to elucidate the mechanism of protective effect in patients with NAFLD.
Departments of Internal Medicine and Liver Research Institute Urology Radiology, Seoul National University College of Medicine, 28 Yeongeon-dong, Jongno-gu, Seoul 110-744, Republic of Korea Department of Urology, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Republic of Korea.
Won-Mook
WM
Choi
Jeong-Hoon
JH
Lee
Jung-Hwan
JH
Yoon
Cheol
C
Kwak
Young Ju
YJ
Lee
Young Youn
YY
Cho
Yun Bin
YB
Lee
Su Jong
SJ
Yu
Yoon Jun
YJ
Kim
Hyeon Hoe
HH
Kim
Hyo-Cheol
HC
Kim
Sung Yong
SY
Cho
Seung Bae
SB
Lee
Hyeon
H
Jeong
Chung Yong
CY
Kim
Hyo-Suk
HS
Lee
D000368:Aged; D005234:Fatty Liver / Q000150:complications* / Q000473:pathology; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D065626:Non-alcoholic Fatty Liver Disease; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000209:etiology* / Q000473:pathology / Q000601:surgery; D012307:Risk Factors
biochemical recurrence; nonalcoholic fatty liver disease; prostate cancer; radical prostatectomy