[Influence of body mass index on histopathological and intraoperative criteria in a consecutive series of patients after robotic-assisted radical prostatectomy].
BACKGROUND
In various studies it has been shown that obesity enhances the risk for a unfavorable pathological tumour stages, higher Gleason scores (GS), positive surgical margins (PSM), and certain perioperative parameters (higher blood loss, higher length of surgery, higher complication rates) after radical prostatectomy. However, for robot-assisted radical prostatectomy (RARP) there are only a few studies addressing this topic with partially conflicting results. Furthermore, none of these studies actually represents the clinical practice pattern as performed in a European centre.


METHODS
Beside further clinical and histopathological parameters, also body mass index (BMI) of patients undergoing RARP was recorded. The following categories were registered: BMI of < 25 kg/m², ≥ 25-29.9 kg/m², and ≥ 30 kg/m² defined as normal weight, overweight, and obesity, respectively. The potential correlation between BMI on the one hand and various criteria of aggressive tumour biology and specific perioperative parameters on the other hand has been examined on univariate and multivariable analyses.


RESULTS
22.8% (n=79), 59% (n=204), and 18.2% (n=63) of patients of the study group presented with normal weight, overweight, and obesity, respectively. Based on the results of various multivariable regression models there was no significant influence of obesity on pathological tumour stage, pN category, undifferentiated tumour growth (≥ GS7b), upgrading, or PSM rates. Furthermore, obese patients showed a significantly higher intraoperative blood loss and a higher length of surgery, which, however, did not result in a higher rate of grade 3a/b complications according to Clavien-Dindo classification after 90 days.


CONCLUSIONS
In the present series of consecutive patients undergoing RARP there was no evidence for a more aggressive tumour biology or a higher complication rate in obese patients.
Urologische Klinik, St. Elisabeth-Klinikum Straubing.
C
C
Gilfrich
Urologische Klinik, Universitätsklinikum der Johann-Wolfgang-Goethe Universität Frankfurt am Main.
A
A
Haferkamp
Urologische Klinik, Universitätsklinikum der Ludwig-Maximilians-Universität München.
S
S
Brookman-May
Urologische Klinik, St. Elisabeth-Klinikum Straubing.
A
A
Ahmed
Urologische Klinik, St. Elisabeth-Klinikum Straubing.
J
J
Peter
Urologische Klinik, St. Elisabeth-Klinikum Straubing.
M
M
Eckerl
MVZ Strahlentherapie, St. Elisabeth-Klinikum Straubing.
C
C
Schäfer
Urologische Klinik, Ruppiner Kliniken GmbH Neuruppin.
S
S
Lebentrau
Urologische Klinik, St. Elisabeth-Klinikum Straubing.
M
M
May
D000368:Aged; D016063:Blood Loss, Surgical; D015992:Body Mass Index; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D018365:Neoplasm, Residual / Q000473:pathology / Q000601:surgery; D009765:Obesity / Q000150:complications; D061646:Operative Time; D011468:Prostatectomy / Q000379:methods*; D011471:Prostatic Neoplasms / Q000473:pathology* / Q000601:surgery*; D012044:Regression Analysis; D012307:Risk Factors; D065287:Robotic Surgical Procedures / Q000379:methods*; D013223:Statistics as Topic