OncologyEffect of BMI on Primary Treatment of Prostate Cancer
Section snippets
Study Population
The study population consisted of patients recruited in the Cancer of the Prostate Strategic Urological Research Endeavor (CaPSURE), a national longitudinal database established in 1995 to document national trends in management as well as oncological and health-related quality of life (HRQOL) outcomes of men with all stages of biopsy-proven prostate adenocarcinoma. Patients were recruited from 40 primarily community-based urology practices (34 community-based, 3 Veteran's Administration, and 3
Results
Of the 13,124 patients enrolled in CaPSUREM as of June 2006, 5041 men met the study inclusion criteria. Table 1 presents the sociodemographic and clinical characteristics of the study cohort. The distribution of BMI categories in the study population was as follows: 28.1% of patients were classified as normal size, 50.5% were overweight, 16.5% were obese, and 4.8% were very obese. More then half of the patients (55%) underwent radical prostatectomy as an initial form of treatment for prostate
Discussion
Our findings suggest that increasing BMI independently predicts nonsurgical modes of prostate cancer treatment (brachytherapy, external beam radiation, active surveillance, and androgen deprivation) even when adjusting for multiple potential clinical and sociodemographic confounders in our statistical model. This trend implies patients, urologists, or both tend to favor nonsurgical prostate cancer treatment for increasing patient obesity.
Whereas obesity has been shown to be a risk factor for
Conclusion
Obese and very obese patients have a lower rate of surgical intervention compared with normal weight patients for the treatment of prostate cancer. Very obese patients have a significantly higher chance of receiving BT or PADT as their primary treatment. Further research on patient and physician decision-making is encouraged to elicit the underlying reasons for these trends.
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Cited by (0)
This study was funded by TAP Pharmaceutical Products, Inc. P.R. Carroll is a study investigator for TAP Pharmaceuticals. C.J. Kane is a paid consultant to Intuitive Surgical and is a member of the speaker's bureau for Boehringer Ingelheim.