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.
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.
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.