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. 2020 Dec;9(6):2713-2722.
doi: 10.21037/tau-20-1352.

Effect of obesity on the prognosis and recurrence of prostate cancer after radical prostatectomy: a meta-analysis

Runtian Luo  1 , Yongbo Chen  1 , Ke Ran  1 , Qing Jiang  1
Affiliations

Effect of obesity on the prognosis and recurrence of prostate cancer after radical prostatectomy: a meta-analysis

Runtian Luo et al. Transl Androl Urol. 2020 Dec.

Abstract

Background: Obesity has been found to be closely related to the increased risk of fatal prostate cancer (PCa), however there remains no evidence that further clarifies the relationship between obesity and the postoperative recurrence and poor prognosis of PCa. In this study, a systematic review and meta-analysis were performed to systematically evaluate the effect of obesity on the prognosis and recurrence of PCa after radical prostatectomy (RP).

Methods: A literature search of the PubMed, Web of Science, and Embase databases was performed covering articles published between January 2013 and January 2020. Articles regarding the correlation between body mass index (BMI) and the prognosis and recurrence of PCa following RP were included in the meta-analysis. Two investigators independently screened the literature and extracted relevant data including publication information, key results, number of cancer cases, and multivariable-adjusted odds ratios (ORs) with 95% confidence intervals (CIs). Meta-analysis was performed using RevMan 5.3 and Stata 16.0 software, and forest plots, funnel plots, and sensitivity analysis were also conducted.

Results: A total of 14 articles were included, all of which were analyzed for clinicopathological characteristics. Eight articles reported the biochemical recurrence (BCR) with prostate-specific antigen (PSA) as the predictor, and six articles reported the positive surgical margins (PSM). The meta-analysis showed that obese PCa patients had more postoperative recurrence and poor prognosis compared with the normal weight PCa patients, and the difference was statistically significant (OR =1.25, 95% CI: 1.10, 1.43). BCR exhibited no significant difference between obese and non-obese PCa patients after surgery (OR =1.2, 95% CI: 0.96, 1.46), and there were also no notable differences in PSM between the groups (OR =1.16, 95% CI: 0.99, 1.36). Subgroup analysis showed that obese PCa patients in the Americas (95% CI: 1.11, 1.37) and Europe (95% CI: 1.11, 1.78) were more likely to have surgical recurrence and poor prognosis (OR =1.40). Obese patients in the Americas were also more likely to have BCR after surgery (95% CI: 1.07, 1.36).

Conclusions: Obesity easily leads to poor prognosis and recurrence of PCa after RP.

Keywords: Obesity; meta-analysis; prognosis; prostate cancer (PCa); recurrence.

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Conflict of interest statement

Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at http://dx.doi.org/10.21037/tau-20-1352). The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Literature screening process.
Figure 2
Figure 2
Forest plot of postoperative recurrence and poor prognosis in obese and non-obese PCa patients. OR, odds ratio; CI, confidence interval; PCa, prostate cancer.
Figure 3
Figure 3
Funnel plot of postoperative recurrence and poor prognosis in obese and non-obese PCa patients. OR, odds ratio; PCa, prostate cancer.
Figure 4
Figure 4
Sensitivity analysis of postoperative recurrence and poor prognosis in obese and non-obese PCa patients. CI, confidence interval; PCa, prostate cancer.
Figure 5
Figure 5
Forest plot (A) and sensitivity analysis plot (B) with BCR as the outcome measure. OR, odds ratio; CI, confidence interval; BCR, biochemical recurrence.
Figure 6
Figure 6
Forest plot (A) and sensitivity analysis plot (B) with PSM as the outcome measure. OR, odds ratio; CI, confidence interval; PSM, positive surgical margin.
See this image and copyright information in PMC

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