Obesity and sarcopenia are associated with worse overall survival (OS) in men with metastatic or castration-resistant prostate cancer, according to data presented at the American Urological Association 2020 Virtual Experience. Greater muscle mass, however, independently predicts longer OS in the men.

“Maintaining nutrition and physical activity likely affect both quality of life and longevity in men with metastatic or castrate-resistant disease,” lead investigator Heather Huelster, MD, of Vanderbilt University Medical Center in Nashville, Tennessee, told Renal & Urology News. “This study explores the complex interplay of body composition and metabolism with advanced prostate cancer outcomes, highlighting the important role of nutritional and lifestyle counseling in comprehensive prostate cancer care.”  

The findings are from a study of 182 men with a mean age of 70.7 years. Sarcopenia (muscle mass less than 550 mm2/m2) was present in 64 patients (40.6%) and obesity (30 kg/m2 or higher) present in 68 men (60.3%). Sarcopenia was associated with worse OS and obesity was associated with better OS over a mean 3.18 years of follow up, Dr Huelster and her colleagues reported in a poster presentation. Higher muscle mass was a significant predictor of longer OS.

On univariate analysis, sarcopenia was associated with a 7-fold increased risk of death, whereas obesity was associated with a 5-fold risk of death. On multivariate analysis, higher muscle mass was a significant predictor of longer OS survival, and increasing age was a significant predictor of worse OS, Dr Huelster’s team reported. Each 1 mm2/m2 increase in muscle mass was significantly associated with a 1% decreased risk of death. Each 1-year increase in age was significantly associated with a 3% increased risk of death.


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The investigators calculated muscle mass by measuring the cross-sectional area of the psoas muscle at the L3 vertebrae and normalizing it to patient height.

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Reference

Huelster H, Xu M, Hatcher J, et al. Association of sarcopenia versus obesity with survival in metastatic or castrate-resistant prostate cancer. Presented at the American Urologic Association 2020 Virtual Experience in May. Poster MP37-07.