title: Impact of body mass index on outcomes of laparoscopic radical prostatectomy with long-term follow-up.
abstract: OBJECTIVE
  The aim of this study was to investigate the impact of body mass index (BMI) on the functional and oncological results of patients who had undergone laparoscopic radical prostatectomy (LRP).
  
  
  METHODS
  In total, 1224 patients with follow-up data (>24 months) were enrolled. Patients were divided into three groups according to BMI (kg/m(2)) as: group 1 (normal, BMI <25, n = 425), group 2 (overweight, 25 ≤ BMI <30, n = 594) and group 3 (obese, BMI ≥ 30, n = 205). Demographic, intraoperative and postoperative data with oncological outcomes were recorded. The impact of obesity on those parameters was evaluated and statistical analyses were performed.
  
  
  RESULTS
  Mean age was 63.8 ± 6.1 years and mean follow-up was 43.1 ± 25.1 months (mean ± SD). There were 425 (34.7%) patients in group 1, 594 (48.5%) in group 2 and 205 (16.8%) in group 3. Operation time, clinical stage and estimated blood loss were significantly higher in group 3 than in the other groups (p < 0.001, p = 0.001 and p = 0.001, respectively). Bilateral nerve-sparing rate and bladder neck-sparing rate were significantly decreased in group 3 compared with the other groups (p = 0.001 and p < 0.038, respectively). Statistically significantly higher pathological stage, tumour volume, positive surgical margin and Gleason scores were determined in group 3 compared with the other groups (p = 0.023, p = 0.018, p = 0.009 and p = 0.028, respectively). There were similar urinary continence rates among the groups. The rate of penetration with or without medication was significantly lower in group 3 than in the other groups (p = 0.593 and p = 0.007, respectively).
  
  
  CONCLUSIONS
  LRP seemed safe and effective in obese patients, with similar mean overall survival, cancer-specific survival, complication rates and continence rates to normal weight patients in the long term.
authors.affiliation: Department of Urology, SLK Kliniken, University of Heidelberg , Heilbronn , Germany.
authors.forename: Ali Serdar
authors.initials: AS
authors.lastname: Gözen
authors.forename: Yigit
authors.initials: Y
authors.lastname: Akin
authors.forename: Ender
authors.initials: E
authors.lastname: Özden
authors.forename: Mutlu
authors.initials: M
authors.lastname: Ates
authors.forename: Marcel
authors.initials: M
authors.lastname: Hruza
authors.forename: Jens
authors.initials: J
authors.lastname: Rassweiler
mesh_terms: D000368:Aged; D016063:Blood Loss, Surgical; D015992:Body Mass Index; D018572:Disease-Free Survival; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D018365:Neoplasm, Residual; D009765:Obesity / Q000150:complications*; D061646:Operative Time; D050177:Overweight / Q000150:complications; D011183:Postoperative Complications; D011467:Prostate / Q000473:pathology; D011468:Prostatectomy / Q000379:methods*; D011471:Prostatic Neoplasms / Q000150:complications / Q000473:pathology / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome; D047368:Tumor Burden
keywords: body mass index; laparoscopy; outcomes; radical prostatectomy; surgery