1
|
Sarychev S, Witt JH, Wagner C, Oelke M, Schuette A, Liakos N, Karagiotis T, Mendrek M, Kachanov M, Graefen M, Vetterlein MW, Meyer CP, Tian Z, Leyh-Bannurah SR. Impact of obesity on perioperative, functional and oncological outcomes after robotic-assisted radical prostatectomy in a high-volume center. World J Urol 2022; 40:1419-1425. [PMID: 35348869 DOI: 10.1007/s00345-022-03989-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 03/06/2022] [Indexed: 10/18/2022] Open
Abstract
OBJECTIVE To compare surgical, oncological and functional outcomes between obese vs. normal-weight prostate cancer (PCa) patients treated with robotic-assisted radical prostatectomy (RARP). MATERIALS AND METHODS We assessed 4555 consecutive RARP patients from a high-volume center 2008-2018. Analyses were restricted to normal-weight vs. obese patients (≥ 30 kg/m2). Multivariable cox regression analyses (MVA) assessed the effect of obesity on biochemical recurrence (BCR), metastatic progression (MP), erectile function and urinary continence recovery. Analyses were repeated after propensity score matching. RESULTS Before matching, higher rates of pathological Gleason Grade group ≥ 4 (14 vs. 18%; p = 0.004) and pT3 stage (33 vs. 35%; p = 0.016) were observed in obese patients, with similar observations for surgery time, blood loss and 30-day wound- and surgical complication rates. For normal-weight vs. obese patients, BCR- and MP-free rates were 86 vs. 85% (p = 0.97) and 97.5 vs.97.8% (p = 0.8) at 48 months. Similarly, rates of erectile function at 36 months and urinary continence at 12 months were 56 vs. 49% (p = 0.012) and 88 vs. 85% (p = 0.003), respectively. Before and after propensity score matching, obesity had no effect on BCR or MP, but a negative effect on erectile function (matched HR 0.87, 95%CI 0.76-0.99; p = 0.029) and urinary continence recovery (matched HR 0.91, 95%CI 0.84-0.98; p = 0.014). CONCLUSIONS Obesity did not represent a risk factor of BCR or MP after RARP despite higher rates of adverse pathological features. However, obesity was associated with higher risk of perioperative morbidity and impaired functional outcomes. Such information is integral for patient counselling. Thus, weight loss before RARP should be encouraged.
Collapse
Affiliation(s)
- Sergey Sarychev
- Department of Urology, Spital Thurgau AG, Frauenfeld, Switzerland
| | - Jorn H Witt
- Prostate Center Northwest, Department of Urology, Pediatric Urology and Uro-Oncology, St. Antonius-Hospital, Gronau, Germany
| | - Christian Wagner
- Prostate Center Northwest, Department of Urology, Pediatric Urology and Uro-Oncology, St. Antonius-Hospital, Gronau, Germany
| | - Matthias Oelke
- Prostate Center Northwest, Department of Urology, Pediatric Urology and Uro-Oncology, St. Antonius-Hospital, Gronau, Germany
| | - Andreas Schuette
- Prostate Center Northwest, Department of Urology, Pediatric Urology and Uro-Oncology, St. Antonius-Hospital, Gronau, Germany
| | - Nikolaos Liakos
- Prostate Center Northwest, Department of Urology, Pediatric Urology and Uro-Oncology, St. Antonius-Hospital, Gronau, Germany
| | - Theodoros Karagiotis
- Prostate Center Northwest, Department of Urology, Pediatric Urology and Uro-Oncology, St. Antonius-Hospital, Gronau, Germany
| | - Mikolaj Mendrek
- Prostate Center Northwest, Department of Urology, Pediatric Urology and Uro-Oncology, St. Antonius-Hospital, Gronau, Germany
| | - Mykyta Kachanov
- Martini-Klinik Prostate Cancer Center Hamburg-Eppendorf, Hamburg, Germany.,Institute of Human Genetics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Markus Graefen
- Martini-Klinik Prostate Cancer Center Hamburg-Eppendorf, Hamburg, Germany
| | - Malte W Vetterlein
- Department of Urology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Christian P Meyer
- Department of Urology, Herford Hospital, Campus OWL, Ruhr-University Bochum, Herford, Germany
| | - Zhe Tian
- Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Center, Montreal, QC, Canada
| | - Sami-Ramzi Leyh-Bannurah
- Prostate Center Northwest, Department of Urology, Pediatric Urology and Uro-Oncology, St. Antonius-Hospital, Gronau, Germany.
| |
Collapse
|
2
|
Tolkach Y, Kristiansen G. An overview of translational prostate cancer cohorts for prognostic and predictive studies. Histopathology 2018; 74:161-170. [PMID: 30565297 DOI: 10.1111/his.13770] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Revised: 10/07/2018] [Accepted: 10/08/2018] [Indexed: 01/04/2023]
Abstract
The aim of this review is to describe the characteristics of patient cohorts commonly used for translational biomarker research in prostate cancer and to outline the most prominent contemporary cohorts which serve as a source of prognostic and predictive biomarkers. A non-systematic review of the literature was performed to identify and summarise well-characterized translational prostate cancer cohorts that provide state-of-the-art characterization of (i) primary and (ii) metastatic and castration-resistant prostate cancer. The main advantages and features of these cohorts are a substantial number of patients, unique patient groups, comprehensive genetic characterisation of tumours using multi-omics/next-generation sequencing approaches, high-quality control standards and fully or partially open data for the research community. This overview includes the contemporary cohorts which serve as a rich source of new targets for prognostic and predictive biomarkers as well as a reference database for validation of known biomarkers, therefore representing the cohorts whose impact extends over the current state of biomarker research into the near future (5-10 years).
Collapse
Affiliation(s)
- Yuri Tolkach
- Institute of Pathology, University Hospital Bonn, Bonn, Germany
| | | |
Collapse
|
3
|
Aref AT, Vincent AD, O'Callaghan ME, Martin SA, Sutherland PD, Hoy AJ, Butler LM, Wittert GA. The inverse relationship between prostate specific antigen (PSA) and obesity. Endocr Relat Cancer 2018; 25:933-941. [PMID: 29941675 DOI: 10.1530/erc-17-0438] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Accepted: 06/25/2018] [Indexed: 12/17/2022]
Abstract
Obese men have lower serum prostate-specific antigen (PSA) than comparably aged lean men, but the underlying mechanism remains unclear. The aim of this study was to determine the effect of obesity on PSA and the potential contributing mechanisms. A cohort of 1195 men aged 35 years and over at recruitment, with demographic, anthropometric (BMI, waist circumference (WC)) and serum hormone (serum testosterone, estradiol (E2)) PSA and hematology assessments obtained over two waves was assessed. Men with a history of prostate cancer or missing PSA were excluded, leaving 970 men for the final analysis. Mixed-effects regressions and mediation analyses adjusting for hormonal and volumetric factors explore the potential mechanisms relating obesity to PSA. After adjusting for age, PSA levels were lower in men with greater WC (P = 0.001). In a multivariable model including WC, age, E2/testosterone and PlasV as predictors, no statistically significant associations were observed between with PSA and either WC (P = 0.36) or PlasV (P = 0.49), while strong associations were observed with both E2/testosterone (P < 0.001) and age (P < 0.001). In the mediation analyses with PlasV as the mediator, the average causal mediation effect (ACME) explained roughly 20% of the total effect of WC on PSA (P = 0.31), while when E2/testosterone is a mediator, the ACME explained roughly 50% of the effect (P < 0.001). Our findings indicate that lower PSA levels in obese men, as compared to normal weight men, can be explained both by hormonal changes (elevated E2/testosterone ratio) and hemodilution. Hormonal factors therefore represent a substantial but underappreciated mediating pathway.
Collapse
Affiliation(s)
- Adel T Aref
- University of Adelaide Medical School and Freemasons Foundation Centre for Men's HealthAdelaide, South Australia, Australia
- South Australian Health and Medical Research InstituteAdelaide, South Australia, Australia
| | - Andrew D Vincent
- University of Adelaide Medical School and Freemasons Foundation Centre for Men's HealthAdelaide, South Australia, Australia
- South Australian Health and Medical Research InstituteAdelaide, South Australia, Australia
| | - Michael E O'Callaghan
- University of Adelaide Medical School and Freemasons Foundation Centre for Men's HealthAdelaide, South Australia, Australia
- Urology UnitSA Health, Repatriation General Hospital, Adelaide, South Australia, Australia
- South Australian Prostate Cancer Clinical Outcomes Collaborative (SA-PCCOC)Adelaide, South Australia, Australia
- Flinders Centre for Innovation in CancerFlinders University, Adelaide, South Australia, Australia
| | - Sean A Martin
- University of Adelaide Medical School and Freemasons Foundation Centre for Men's HealthAdelaide, South Australia, Australia
- South Australian Health and Medical Research InstituteAdelaide, South Australia, Australia
| | - Peter D Sutherland
- Department of UrologyRoyal Adelaide Hospital, Adelaide, South Australia, Australia
| | - Andrew J Hoy
- Discipline of PhysiologySchool of Medical Sciences and Bosch Institute, Charles Perkins Centre, University of Sydney, Sydney, New South Wales, Australia
| | - Lisa M Butler
- University of Adelaide Medical School and Freemasons Foundation Centre for Men's HealthAdelaide, South Australia, Australia
- South Australian Health and Medical Research InstituteAdelaide, South Australia, Australia
| | - Gary A Wittert
- University of Adelaide Medical School and Freemasons Foundation Centre for Men's HealthAdelaide, South Australia, Australia
- South Australian Health and Medical Research InstituteAdelaide, South Australia, Australia
| |
Collapse
|
4
|
De Nunzio C, Lombardo R, Nacchia A, Tema G, Tubaro A. Repeat prostate-specific antigen (PSA) test before prostate biopsy: a 20% decrease in PSA values is associated with a reduced risk of cancer and particularly of high-grade cancer. BJU Int 2018. [PMID: 29533522 DOI: 10.1111/bju.14197] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
OBJECTIVES To analyse the impact of repeating a prostate-specific antigen (PSA) level assessment on prostate biopsy decision in a cohort of men undergoing prostate biopsy. PATIENTS AND METHODS From 2015 onwards, we consecutively enrolled, at a single institution in Italy, men undergoing 12-core transrectal ultrasonography-guided prostate needle biopsy. Indication for prostate biopsy was a PSA level of ≥4 ng/mL. Demographic, clinical, and histopathological data were collected. The PSA level was tested at enrolment (PSA1 ) and 4 weeks later on the day before biopsy (PSA2 ). Variations in PSA level were defined as: stable PSA2 within a 10% variation, stable PSA2 within a 20% variation, PSA2 decreased by ≥10%, PSA2 decreased by ≥20%, PSA2 increased by ≥10%, PSA2 increased by ≥20%, and PSA2 <4 ng/mL. Percentages and multinomial logistic regression were used to analyse biopsy outcomes. High-grade cancer was defined as Grade group ≥3. RESULTS Overall, 331 patients were enrolled. Prostate cancer was diagnosed in 153/331 (46%) patients and of them 80/153 (52%) had high-grade disease. When compared to the rest of the population, patients with a stable PSA within 20% variation had a higher risk of prostate cancer (odds ratio [OR] 1.80, P < 0.05) and high grade disease (OR 2.56, P < 0.05), patients with a PSA2 decreased by ≥20% had a lower risk of prostate cancer (OR 0.37, P < 0.05) and high grade disease (OR 0.13, P < 0.05), whilst patients with a PSA2 increased by ≥10% had an increased risk of high-grade prostate cancer (OR 1.93, P < 0.05). When PSA returned to normal values (<4 ng/mL) both risks of prostate cancer and high-grade disease were reduced (OR 0.33 and 0.01, respectively, P = 0.001). CONCLUSION In a cohort of Italian men undergoing prostate biopsy, a reduction of ≥20% in PSA levels significantly reduced the risk of high-grade prostate cancer. Further multicentre studies should validate our present results.
Collapse
Affiliation(s)
- Cosimo De Nunzio
- Department of Urology, Ospedale Sant'Andrea, 'Sapienza' University of Rome, Rome, Italy
| | - Riccardo Lombardo
- Department of Urology, Ospedale Sant'Andrea, 'Sapienza' University of Rome, Rome, Italy
| | - Antonio Nacchia
- Department of Urology, Ospedale Sant'Andrea, 'Sapienza' University of Rome, Rome, Italy
| | - Giorgia Tema
- Department of Urology, Ospedale Sant'Andrea, 'Sapienza' University of Rome, Rome, Italy
| | - Andrea Tubaro
- Department of Urology, Ospedale Sant'Andrea, 'Sapienza' University of Rome, Rome, Italy
| |
Collapse
|
5
|
Sanchis-Bonet A, Morales-Palacios N, Barrionuevo-Gonzalez M, Ortega-Polledo LE, Ortiz-Vico FJ, Sanchez-Chapado M. Does obesity modify prostate cancer detection in a European cohort? Cent European J Urol 2017; 70:30-36. [PMID: 28461985 PMCID: PMC5407327 DOI: 10.5173/ceju.2017.881] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Revised: 10/01/2016] [Accepted: 11/24/2016] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION To investigate prostate-specific antigen (PSA) accuracy and digital rectal examination (DRE) accuracy in detecting prostate cancer according to body mass index (BMI) in Spanish men with an indication of the first prostate biopsy. MATERIAL AND METHODS We reviewed the clinical and histopathological data of 1,319 patients who underwent transrectal ultrasound-guided prostate needle biopsy. The patients were categorised according to the BMI as follows: <25 kg/m2 (normal weight); 25-29.9 kg/m2 (overweight); and ≥30 kg/m2 (obese). Receiver operator characteristic curves were used to assess PSA accuracy and DRE accuracy by calculating the area under the curve. RESULTS The obesity rate of the cohort was 14%. PSA accuracy for predicting prostate cancer in each BMI category was 0.52, 0.58 and 0.62, respectively (p = 0.01). After stratification by DRE findings, there was no difference in the performance accuracy of PSA in predicting the presence of cancer across BMI groups in abnormal DRE (p = 0.90). Serum PSA, DRE and BMI were strong predictors of prostate cancer diagnosis (odds ratio 1.07, 2.02 and 1.4, respectively; p <0.001). When the DRE was abnormal, a BMI ≥30 increased the risk of prostate cancer twice. With the addition of BMI to the model, the area under the curve of the combined PSA and DRE for diagnosing prostate cancer improved from 0.60 to 0.63. CONCLUSIONS The predictive value of PSA in predicting prostate cancer is not poorer in the obese population and the predictive value of an abnormal DRE in cancer detection is significantly modified by the patient's BMI.
Collapse
|
6
|
Tai SY, Huang SP, Bao BY, Wu MT. Urinary melatonin-sulfate/cortisol ratio and the presence of prostate cancer: A case-control study. Sci Rep 2016; 6:29606. [PMID: 27387675 PMCID: PMC4937372 DOI: 10.1038/srep29606] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2016] [Accepted: 06/22/2016] [Indexed: 12/29/2022] Open
Abstract
The circadian-related hormones, melatonin and cortisol, have oncostatic and immunosuppressive properties. This study examined the relationship between these two biomarkers and the presence of prostate cancer. We measured their major metabolites in urine collected from 120 newly diagnosed prostate cancer patients and 240 age-matched controls from January 2011 to April 2014. Compared with patients with lower urinary melatonin-sulfate or melatonin-sulfate/cortisol (MT/C) ratio levels, those with above-median levels were significantly less likely to have prostate cancer (adjusted OR (aOR) = 0.59, 95% CI = 0.35–0.99; aOR = 0.46, 95% CI: 0.27–0.77) or advanced stage prostate cancer (aOR = 0.49, 95% CI = 0.26–0.89; aOR = 0.33, 95% CI = 0.17–0.62). The combined effect of both low MT/C ratios and PSA levels exceeding 10 ng/ml was an 8.82-fold greater likelihood of prostate cancer and a 32.06-fold greater likelihood of advanced stage prostate cancer, compared to those with both high MT/C ratios and PSA levels less than 10 ng/ml. In conclusion, patients with high melatonin-sulfate levels or a high MT/C ratio were less likely to have prostate cancer or advanced stage prostate. Besides, a finding of a low MT/C ratio combined with a PSA level exceeding 10 ng/ml showed the greatest potential in detecting prostate cancer and advanced stage prostate cancer.
Collapse
Affiliation(s)
- Shu-Yu Tai
- Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Family Medicine, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Family Medicine, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, Taiwan.,Department of Family Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.,Research Center for Environmental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Shu-Pin Huang
- Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Urology, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.,Institute of Biomedical Science, National Sun Yat-Sen University, Kaohsiung, Taiwan
| | - Bo-Ying Bao
- Department of Pharmacy, China Medical University, Taichung, Taiwan.,Sex Hormone Research Center, China Medical University Hospital, Taichung, Taiwan.,Department of Nursing, Asia University, Taichung, Taiwan
| | - Ming-Tsang Wu
- Department of Family Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.,Research Center for Environmental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Public Health, Kaohsiung Medical University, Kaohsiung Medical University, Kaohsiung, Taiwan.,Center of Environmental and Occupational Medicine, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| |
Collapse
|
7
|
Effect of body mass index on the performance characteristics of PSA-related markers to detect prostate cancer. Sci Rep 2016; 6:19034. [PMID: 26754552 PMCID: PMC4709513 DOI: 10.1038/srep19034] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2015] [Accepted: 12/02/2015] [Indexed: 12/29/2022] Open
Abstract
To examine whether the predictive performance of prostate-specific antigen (PSA) and PSA-related markers for prostate cancer (PCa) is modified by body mass index (BMI). Patients with a PSA 2-10 ng/mL who underwent multicore prostate biopsies were recruited from three tertiary centers. Serum markers measured included total PSA (tPSA), free-to-total PSA (f/tPSA), p2PSA, percentage of p2PSA (%p2PSA), and prostate health index (PHI). The association between serum markers and PCa risk was assessed by logistic regression. Predictive performance for each marker was quantified using the area under the receiver operator curves (AUC). Among 516 men, 18.2% had PCa at biopsy. For all tested markers, their predictive value on PCa risk was lower in obese patients compared to normal weight patients. We found statistically significant interactions between BMI and tPSA (P = 0.0026) and p2PSA (P = 0.038). PHI achieved an AUC of 0.872 in normal weight patients and 0.745 in obese patients, which outperformed the other predictors regardless of BMI category. In conclusion, PHI achieved the best predictive performance for detecting PCa and was not influenced by BMI.
Collapse
|
8
|
Does Obesity Modify the Ability of Prebiopsy Prostate Specific Antigen to Detect Prostate Cancer on Repeat Biopsy? Results from the REDUCE Study. J Urol 2015; 194:52-7. [DOI: 10.1016/j.juro.2015.01.111] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/30/2015] [Indexed: 11/22/2022]
|
9
|
Abrate A, Lazzeri M, Lughezzani G, Buffi N, Bini V, Haese A, de la Taille A, McNicholas T, Redorta JP, Gadda GM, Lista G, Kinzikeeva E, Fossati N, Larcher A, Dell'Oglio P, Mistretta F, Freschi M, Guazzoni G. Clinical performance of the Prostate Health Index (PHI) for the prediction of prostate cancer in obese men: data from the PROMEtheuS project, a multicentre European prospective study. BJU Int 2015; 115:537-45. [PMID: 25130593 DOI: 10.1111/bju.12907] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
OBJECTIVES To test serum prostate-specific antigen (PSA) isoform [-2]proPSA (p2PSA), p2PSA/free PSA (%p2PSA) and Prostate Health Index (PHI) accuracy in predicting prostate cancer in obese men and to test whether PHI is more accurate than PSA in predicting prostate cancer in obese patients. PATIENTS AND METHODS The analysis consisted of a nested case-control study from the pro-PSA Multicentric European Study (PROMEtheuS) project. The study is registered at http://www.controlled-trials.com/ISRCTN04707454. The primary outcome was to test sensitivity, specificity and accuracy (clinical validity) of serum p2PSA, %p2PSA and PHI, in determining prostate cancer at prostate biopsy in obese men [body mass index (BMI) ≥30 kg/m(2) ], compared with total PSA (tPSA), free PSA (fPSA) and fPSA/tPSA ratio (%fPSA). The number of avoidable prostate biopsies (clinical utility) was also assessed. Multivariable logistic regression models were complemented by predictive accuracy analysis and decision-curve analysis. RESULTS Of the 965 patients, 383 (39.7%) were normal weight (BMI <25 kg/m(2) ), 440 (45.6%) were overweight (BMI 25-29.9 kg/m(2) ) and 142 (14.7%) were obese (BMI ≥30 kg/m(2) ). Among obese patients, prostate cancer was found in 65 patients (45.8%), with a higher percentage of Gleason score ≥7 diseases (67.7%). PSA, p2PSA, %p2PSA and PHI were significantly higher, and %fPSA significantly lower in patients with prostate cancer (P < 0.001). In multivariable logistic regression models, PHI significantly increased accuracy of the base multivariable model by 8.8% (P = 0.007). At a PHI threshold of 35.7, 46 (32.4%) biopsies could have been avoided. CONCLUSION In obese patients, PHI is significantly more accurate than current tests in predicting prostate cancer.
Collapse
Affiliation(s)
- Alberto Abrate
- Division of Oncology, Unit of Urology, URI, Milan, Italy
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
10
|
Serum 17β-estradiol fails as a marker in identification of aggressive tumour disease in patients with localized prostate cancer. World J Urol 2015; 33:1979-84. [DOI: 10.1007/s00345-015-1567-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2015] [Accepted: 04/17/2015] [Indexed: 10/23/2022] Open
|
11
|
Kim JH, Doo SW, Yang WJ, Lee KW, Lee CH, Song YS, Jeon YS, Kim ME, Kwon SS. Impact of obesity on the predictive accuracy of prostate-specific antigen density and prostate-specific antigen in native Korean men undergoing prostate biopsy. Int J Urol 2014; 21:987-90. [DOI: 10.1111/iju.12486] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2014] [Accepted: 04/06/2014] [Indexed: 11/30/2022]
Affiliation(s)
- Jae Heon Kim
- Department of Urology; College of Medicine; Soonchunhyang University; Cheonan South Korea
| | - Seung Whan Doo
- Department of Urology; College of Medicine; Soonchunhyang University; Cheonan South Korea
| | - Won Jae Yang
- Department of Urology; College of Medicine; Soonchunhyang University; Cheonan South Korea
| | - Kwang Woo Lee
- Department of Urology; College of Medicine; Soonchunhyang University; Cheonan South Korea
| | - Chang Ho Lee
- Department of Urology; College of Medicine; Soonchunhyang University; Cheonan South Korea
| | - Yun Seob Song
- Department of Urology; College of Medicine; Soonchunhyang University; Cheonan South Korea
| | - Yoon Su Jeon
- Department of Urology; College of Medicine; Soonchunhyang University; Cheonan South Korea
| | - Min Eui Kim
- Department of Urology; College of Medicine; Soonchunhyang University; Cheonan South Korea
| | - Soon-Sun Kwon
- Medical Research Collaborating Center; Seoul National University Bundang Hospital; Seongnam South Korea
| |
Collapse
|
12
|
Obese men have more advanced and more aggressive prostate cancer at time of surgery than non-obese men after adjusting for screening PSA level and age: results from two independent nested case-control studies. Prostate Cancer Prostatic Dis 2013; 16:352-6. [PMID: 23958895 PMCID: PMC3826034 DOI: 10.1038/pcan.2013.27] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2013] [Revised: 06/27/2013] [Accepted: 07/21/2013] [Indexed: 11/08/2022]
Abstract
BACKGROUND: It remains unclear whether the hemodilution effect of body mass index (BMI) on PSA levels translates to inappropriate prostate cancer (PCa) screening in obese men. To address this, we conducted two nested case–control studies within prospective cohorts of men undergoing radical prostatectomy for newly diagnosed PCa. METHODS: We identified 1817 men with BMI ⩾30 kg m−2 (cases) and 1244 men with BMI <25 kg m−2 (controls) who underwent surgery to treat PCa at Mayo Clinic in Rochester between 2000 and 2009. Cases and controls were frequency matched on age and PSA level. In a similar manner, we identified 206 cases and 133 controls treated at Mayo Clinic in Florida between 2006 and 2011. We employed logistic regression models to evaluate the association of pathologic features of aggressiveness with obesity status. RESULTS: After adjusting for age and PSA level, we noted that obese men in the Rochester population are more likely to present with Gleason grade 8–10 tumors (OR= 1.50; 95% CI 1.14–1.96; P=0.003) and pT3, pT4, pTxN+ stage disease (OR=1.30; 95% CI 1.05–1.62). We noted a similar association seminal vesicle involvement (OR= 1.41; 95% CI 1.03–1.92; P=0.03). Results from the smaller Florida population supported these same associations but did not achieve conventional statistical significance. CONCLUSIONs: Obese men present with more aggressive PCa tumors compared with non-obese men of similar age and PSA screening values. If confirmed, this would support the need to explore PSA-based screening in obese men to possibly account for a hemodilution effect.
Collapse
|
13
|
|