(19-01-06) Obesity increases risk of prostate cancer recurrence

NEW YORK (Reuters Health) - Prostate cancer recurrence after radical prostatectomy is more common among obese men compared to those of normal weight, a new study shows.

The effect of obesity on prostate cancer incidence and recurrence is "controversial," Dr. Christopher J. Kane of the University of California at San Francisco and colleagues report. However, they note, two recent retrospective studies found recurrence of the disease was more common among obese men.
To investigate the association further, the researchers evaluated data on 2,131 men from the Cancer of the Prostate Strategic Urologic Research Endeavor (CapSURE) database who had undergone radical prostatectomy. Twelve percent of men developed recurrent disease during follow-up, which lasted a median 23 months.
A significant association between body mass index (BMI) and disease recurrence remained after adjustment for risk group, ethnicity, age and comorbidities, the researchers found. Men with BMIs of 35 kg/m2 or greater were 69% more likely to have recurrence of prostate cancer than men whose BMIs were 25 kg/m2 or less. Men with BMIs greater than 30 kg/m2 had a 31% increased risk of recurrence than men with BMIs of 30 kg/m2 or below.
There are a number of potential mechanisms through which obesity could promote prostate recurrence, the researchers note, from the effect of excess adipose tissue on hormone levels to the difficulty of operating on obese patients.
"Because of both increased comorbidities and greater rates of recurrence, obese individuals undergoing radical prostatectomy require vigilant follow-up care," the researchers write in the November issue of Urology.
"Continued research is necessary to evaluate the efficacy of other treatments in obese patients with prostate cancer, as well as to clarify how prostate cancer recurrence affects survival in obese patients," they add.

Source : Urology 2005;66:1060-1065.

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