Recommendations on Weight Loss and Healthy Lifestyle in Prostate Cancer Clinical Guidelines: A Systematic Review.

Mario Rivera-Izquierdo,Virginia Martínez-Ruiz,José Juan Jiménez-Moleón

doi:10.3390/ijerph19031452

Abstract

Obesity is associated with negative prostate cancer outcomes (e.g., specific mortality, all-cause mortality, biochemical recurrence, etc.), according to the current scientific literature. Nevertheless, recommendations on weight loss and healthy lifestyles are poorly covered by clinicians. We aimed at identifying these recommendations from clinical practice guidelines (CPGs) for prostate cancer. We systematically searched MEDLINE, EMBASE, Web of Science, Scopus, guideline databases and online sources for CPGs updated from January 2015 to August 2021. The searches were independently conducted by two researchers, without language restrictions. A total of 97 prostate cancer guidelines, including 84 (86.6%) CPGs and 13 (13.4%) consensus statements, were included. Recommendations on reaching and maintaining a healthy weight or healthy lifestyles were provided by 7 (7.2%) and 13 (13.4%) documents, respectively. No differences regarding recommendations were found by type of document, year of publication or country. Our results suggest that professional societies and governments should update prostate cancer guidelines to include these recommendations for improving prostate cancer prognosis.

Highlights

Academic Editor: David BerriganProstate cancer (PC) is the most frequent cancer in men [1]
New studies on the molecular mechanisms linking obesity to prostate cancer have been developed [7], and several systematic reviews and meta-analyses have pointed to obesity, measured as body mass index (BMI) ≥ 30 kg/m2, as a prognostic factor associated with a higher frequency of prostate cancer specific mortality [8], higher frequency of all-cause mortality [8] and higher frequency of biochemical recurrence after radical prostatectomy [9]
PC-specific mortality, all-cause mortality and biochemical recurrence have been reported to be increased in obese patients [8,9]; current studies are focused on testing programs for reaching and maintaining a healthy weight after PC diagnosis [16,17,18,19]

Summary

Introduction

Academic Editor: David BerriganProstate cancer (PC) is the most frequent cancer in men [1]. New studies on the molecular mechanisms linking obesity to prostate cancer have been developed [7], and several systematic reviews and meta-analyses have pointed to obesity, measured as body mass index (BMI) ≥ 30 kg/m2 , as a prognostic factor associated with a higher frequency of prostate cancer specific mortality [8], higher frequency of all-cause mortality [8] and higher frequency of biochemical recurrence after radical prostatectomy [9]. Other authors have reported the increased difficulties of prostate cancer surgery in obese patients, which can lead to adverse events or disease recurrence [11], and a higher association with the need for chemotherapy [12]. Other recent studies have pointed to an association between higher BMI and multiple pelvic lymph node metastasis [13]

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