PSM Linked to Obesity in Men with Locally Advanced Prostate Cancer

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Edouard J. Trabulsi, MD
Edouard J. Trabulsi, MD

SAN FRANCISCO—Obesity is associated with higher positive surgical margin (PSM) rates after robotic-assisted laparoscopic prostatectomy (RALP), a study found.

A team at Thomas Jefferson University in Philadelphia led by Edouard J. Trabulsi, MD, Associate  Professor of Urology, studied 589 patients who under RALP for prostate cancer and had BMI information recorded at the time of surgery. They defined obesity as a BMI of 30 kg/m2 or higher.

The PSM rate was significantly higher in obese than non-obese men (29.2% vs. 18.3%), according to findings presented here at the Genitourinary Cancers Symposium.

When the researchers stratified by organ-confined (pT2) and non-organ-confined (pT3/pT4) disease, they observed no difference in PSM for obese and non-obese patients for organ-confined disease (18.4% vs. 13.6%, respectively). Obese patients with locally advanced disease, however, had a significantly higher PSM rate than non-obese subjects (62.5% vs. 41.4%). Locally advanced disease occurred in 26.1% of the obese subjects compared with 17.4% of non-obese patients.

Explaining the study's findings, Dr. Trabulsi noted that prostate surgery is technically more difficult in obese patients, which could increase the likelihood of PSMs. The findings are in line with previous research suggesting that obese patients are at higher risk of harboring more advanced disease than non-obese patients, he noted.

The symposium is sponsored by the American Society of Clinical Oncology, the American Society for Radiation Oncology, and the Society of Urologic Oncology.

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