Prostate cancer (PCa) patients who are obese are no more likely than those of normal weight to have a higher prebiopsy PSA level or higher-risk disease, according to researchers.
Consequently, obese PCa patients might not benefit from more aggressive treatment options, they concluded.
Karim Chamie, MD, and colleagues at the University of California Los Angeles reviewed data on 573 men with a mean age of 61.5 years and median prebiopsy PSA level of 6.7 ng/mL. More than 70% of the men were overweight. On multivariate analysis, the investigators found no association between BMI and prebiopsy PSA level, Gleason score, clinical T stage, or D’Amico risk, researchers reported online ahead of print in Urology.
Advancing age was associated with a greater risk of a higher prebiopsy PSA level, Gleason score, and D’Amico tumor risk.
In a discussion of study limitations, Dr. Chamie’s team noted that their study was retrospective and thus subject to omitted variable bias. In addition, prebiopsy PSA levels were measured at multiple facilities during a seven-year period, making the findings susceptible to laboratory heterogeneity.
“Although the debate over PSA and obesity will continue, the more pressing issue is how to treat those diagnosed with cancer,” the authors wrote. “Overuse of surgery and radiotherapy among obese men with indolent cancer (clinically) could result in unnecessary morbidity from treatment, especially in a cohort that might be at greater risk of complications.”