Obesity men with metastatic castration-resistant prostate cancer (mCRPC) have better overall and cancer-specific and survival compared with their overweight or normal-weight counterparts, data presented as part of the American Urological Association 2020 Virtual Experience suggest.
In a study of 1577 mCRPC patients from the control arms of 3 phase III randomized trials (ASCENT2, MAINSAL, and VENICE), Alberto Martini, MD, of the Università Vita-Salute San Raffaele in Milan, and colleagues found that obesity (body mass index [BMI] higher than 30 kg/m2) was significantly associated with a 29% decreased risk of death from any cause and 35% decreased risk of cancer-specific death compared with patients who were not obese. Each 1 kg/m2 increment in BMI was significantly associated with a 4% decreased risk of death from any cause and 6% decreased risk of cancer-related death.
To exclude the possible effects attributable to a higher dose of chemotherapy, the investigators looked for interactions between BMI and chemotherapy dose. They found no association between BMI or chemotherapy dose.
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The current study builds on previous evidence of an inverse relationship between BMI and outcomes in men with prostate cancer. For example, in a study of 13,667 men who underwent RP, obese men (BMI of 30 kg/m2 or higher) had a significant 30% decreased risk of metastases developing after surgery compared with those who had a BMI below 25 kg/m2, Jonas Schiffmann, MD, of Academic Hospital Braunschweig in Brunswick, Germany, and colleagues reported in the World Journal of Urology. After propensity score adjustment, obesity was significantly associated with increased metastasis-free survival. The study had a median follow-up of 36.4 months.
References
Martini A, Sfakianos JP, Gandaglia G, et al. The inverse correlation between obesity and mortality in patients with metastatic castration-resistant resistant prostate cancer: Results from the control arms of ASCENT2, MAINSAL and VENICE trials. Presented during the American Urological Association 2020 Virtual Experience held in May. Abstract PD16-05.
Schiffmann J, Karakiewicz PI, Rink M, et al. Obesity paradox in prostate cancer: increased body mass index was associated with decreased risk of metastases after surgery in 13,667 patients. World J Urol. 2018;36:1067-1072. doi: 10.1007/s00345-018-2240-8. Epub 2018 Mar 2.
