Prostatic fatty acids and cancer recurrence after radical prostatectomy for early-stage prostate cancer

Abstract

Results from some observational studies suggest that diet and energy balance influence the clinical course of early-stage prostate cancer. To evaluate possible mechanisms, we prospectively examined the relation between prostatic concentrations of fatty acids at diagnosis and cancer recurrence following primary therapy. Fatty acids were measured by capillary gas chromatography in fresh, non-cancerous prostate tissue collected from 184 men undergoing radical prostatectomy for clinically localized prostate cancer. Their association with risk of biochemical disease recurrence (a rising serum prostate-specific antigen following a disease-free [<0.1 ng/ml] interval > or =6 months) was analyzed using Cox proportional hazards models incorporating patient age, body mass index, tumor characteristics at diagnosis, and ethnicity. During an average follow-up of 48.7 months (median = 47), 14 patients experienced biochemical recurrence. Percent total polyunsaturated fatty acid and the ratio of oleic-to-stearic acid associated with risk (multivariable hazards ratio [HR] = 0.51, 95% confidence interval [CI] = 0.29 to 0.90, p = 0.021 and HR = 1.68, 95% CI = 1.21 to 2.33, p = 0.002, respectively, per 1 standard deviation increase). The results of this study are preliminary, but they suggest that pre-diagnostic prostatic concentrations of fatty acids associate with risk of biochemical recurrence following radical prostatectomy for clinically localized prostate cancer.