¿Es la obesidad un factor predictor de agresividad en cáncer de próstata?

Abstract

AimsTo describe the relation between obesity and prostate cancer (CaP) aggressiveness in a Mexican population. MethodsData was collected retrospectively from the electronic medical files of 167 patients with CaP. They were grouped according to body mass index (BMI), age, Gleason score, clinical stage, and D’Amico classification. The variables were correlated (BMI, prostate-specific antigen [PSA], clinical stage, Gleason score) and were analyzed using statistical models. ResultsA total of 167 patients with CaP were studied. The mean age was 69.4 years and mean pre-biopsy PSA was 25.36ng/m. Overweight was present as Grade I and Grade II obesity in 45% and 22.75% of the patients, respectively, and 25.7% were within their normal weight range. A total of 41.9% of the patients had a Gleason score of 6 and 47.9% of the tumors were classified as stage cT1c. According to the D’Amico classification, 11.37% of the patients were considered at low risk for aggressive CaP, 23.95% at intermediate risk, and 64.67% were at high risk. Those patients with a BMI > 25kg/m2 presented with a greater risk for high-risk CaP (OR 1.027; P=.46) and those with a BMI>25kg/m2 had a greater risk for a Gleason score of 8-10 (OR 1.310; P=.23). We identified a relation between BMI>25kg/m2 and PSA<20ng/mL (OR 1.14; P=.36) and a negative association between BMI>25kg/m2 and PSA>20ng/mL (OR 0.87; P=.35). No significant difference was found between BMI and clinical stage (OR 0.89; P=0.15). ConclusionsObese patients are at a higher risk for aggressive CaP; they presented with a lower PSA and the overweight and obese patients had a higher Gleason score. These data will enable us to make better preventive and therapeutic decisions in overweight and obese men with CaP.