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Clinical Trial
. 2007 Dec 15;110(12):2691-9.
doi: 10.1002/cncr.23093.

Obesity and mortality in men with locally advanced prostate cancer: analysis of RTOG 85-31

Jason A Efstathiou  1 , Kyounghwa Bae, William U Shipley, Gerald E Hanks, Miljenko V Pilepich, Howard M Sandler, Matthew R Smith
Affiliations
Clinical Trial

Obesity and mortality in men with locally advanced prostate cancer: analysis of RTOG 85-31

Jason A Efstathiou et al. Cancer. .

Abstract

Background: Greater body mass index (BMI) is associated with shorter time to prostate-specific antigen (PSA) failure following radical prostatectomy and radiation therapy (RT). Whether BMI is associated with prostate cancer-specific mortality (PCSM) was investigated in a large randomized trial of men treated with RT and androgen deprivation therapy (ADT) for locally advanced prostate cancer.

Methods: Between 1987 and 1992, 945 eligible men with locally advanced prostate cancer were enrolled in a phase 3 trial (RTOG 85-31) and randomized to RT and immediate goserelin or RT alone followed by goserelin at recurrence. Height and weight data were available at baseline for 788 (83%) subjects. Cox regression analyses were performed to evaluate the relations between BMI and all-cause mortality, PCSM, and nonprostate cancer mortality. Covariates included age, race, treatment arm, history of prostatectomy, nodal involvement, Gleason score, clinical stage, and BMI.

Results: The 5-year PCSM rate for men with BMI <25 kg/m(2) was 6.5%, compared with 13.1% and 12.2% in men with BMI > or =25 to <30 and BMI > or =30, respectively (Gray's P = .005). In multivariate analyses, greater BMI was significantly associated with higher PCSM (for BMI > or =25 to <30, hazard ratio [HR] 1.52, 95% confidence interval [CI], 1.02-2.27, P = .04; for BMI > or =30, HR 1.64, 95% CI, 1.01-2.66, P = .04). BMI was not associated with nonprostate cancer or all-cause mortality.

Conclusions: Greater baseline BMI is independently associated with higher PCSM in men with locally advanced prostate cancer. Further studies are warranted to evaluate the mechanism(s) for increased cancer-specific mortality and to assess whether weight loss after prostate cancer diagnosis alters disease course.

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Figures

FIGURE 1
FIGURE 1
Time to (top) prostate cancer-specific mortality (PCSM); (middle) non-PCSM; and (bottom) all-cause mortality (ACM) by treatment arm for the 788 subjects with available body mass index (BMI).
FIGURE 2
FIGURE 2
Time to prostate cancer-specific mortality (PCSM) by body mass index (BMI) category.
See this image and copyright information in PMC

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