PD31-12 OBESITY AND HYPOGONADISM ARE ASSOCIATED WITH AN INCREASED RISK OF PREDOMINANT GLEASON 4 PATTERN ON RADICAL PROSTATECTOMY SPECIMEN

Abstract

You have accessJournal of UrologyProstate Cancer: Epidemiology & Natural History I1 Apr 2014PD31-12 OBESITY AND HYPOGONADISM ARE ASSOCIATED WITH AN INCREASED RISK OF PREDOMINANT GLEASON 4 PATTERN ON RADICAL PROSTATECTOMY SPECIMEN Yann Neuzillet, Tarek Ghoneim, Audrey Pichon, Thierry Lebret, Vincent Molinie, Camelia Radulescu, Henry Botto, and Jean-Pierre Raynaud Yann NeuzilletYann Neuzillet More articles by this author , Tarek GhoneimTarek Ghoneim More articles by this author , Audrey PichonAudrey Pichon More articles by this author , Thierry LebretThierry Lebret More articles by this author , Vincent MolinieVincent Molinie More articles by this author , Camelia RadulescuCamelia Radulescu More articles by this author , Henry BottoHenry Botto More articles by this author , and Jean-Pierre RaynaudJean-Pierre Raynaud More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.2271AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Obesity, defined by a body mass index (BMI) ≥ 30 kg/m2, increases the likelihood prostate cancer. Obesity was associated with worse outcome, especially more frequent biochemical recurrence after radical prostatectomy. However, the mechanisms of these associations are unclear. This study aims to compare histological feature of prostate cancer according to both BMI and gonadal status in patients who underwent radical prostatectomy. METHODS Between 3/2007 and 9/2013, clinical, pathological and biological data have been prospectively collected for patients referred for radical prostatectomy in a single centre. Preoperative Total Testosterone (TT) and bioavailable Testosterone (bioT) serum determinations (samplings between 7 and 10 am; radio-immuno assayed in a central laboratory) were done. The threshold for hypogonadism was set at TT < 3 ng/mL. Gleason Score (GS) and predominant Gleason Pattern (pGP) were determined in prostate tissue specimens, and cross-checked by two uro-pathologists. Uni- and Multivariable analyses were done for pGP4 risk assessment. RESULTS Nine hundred and thirty seven consecutive patients were included. Mean age was 63±6 years. Means PSA, BMI and TT and bioT values were 8.48±5.49 ng/ml, 26.4±3.6 kg/m2, 4.60±1.67 ng/mL and 1.35±0.62 ng/mL respectively. 135 fill criterium for obesity (14.4%), out of which 42 had TT < 3 ng/mL (31.1%), while in the 802 non obese patients, only 97 had TT< 3 ng/ml (12.0%). In prostate specimens, mean GS was 6.8±0.5: 291 patients (31.1%) had a pGP4. The incidence of pGP4 was higher(p<0.001) in the 135 obese patients (50% when hypogonadal (p<0.02) or 42% when eugonadal(p<0.005) than in non obese patients ((28.9% and 27.1% respectively.)) In univariable analyses, pGP4 patients have higher BMI (27.3±4.1 vs 26.0±3.3 kg/m2, p<0.001), lower TT (4.40±1.67 vs 4.69±1.67 ng/mL, p=0.017), higher PSA (10.2±7.1 vs 7.7±4.4 ng/mL, p<0.001), and were older (64.5±6.5 vs 62.6±6.9 years, p<0.001). In multivariable analysis for pGP4 risk, obesity (OR=1.102, 95%CI=[1.057;1.149], p<0.001), TT<3 ng/mL (OR=1.544, 95%CI=[1.038;2.297], p=0.032), PSA (OR=1.084, 95%CI=[1.054;1.115], p<0.001) and age (OR=1.044, 95%CI=[1.021;1.067], p<0.001) were independent risk factors. CONCLUSIONS Both obesity and hypogonadism are independent risk factors for pGP4 in patients who underwent radical prostatectomy. These two factors should be taken into account in localized prostate cancer management, to improve the therapeutic choice, especially when prostate sparing approach is considered. © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e835 Advertisement Copyright & Permissions© 2014MetricsAuthor Information Yann Neuzillet More articles by this author Tarek Ghoneim More articles by this author Audrey Pichon More articles by this author Thierry Lebret More articles by this author Vincent Molinie More articles by this author Camelia Radulescu More articles by this author Henry Botto More articles by this author Jean-Pierre Raynaud More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...