Editor's Commentary - Prostate cancer postoperative nomogram scores and obesity

BERKELEY, CA (UroToday.com) - In PLoS One, Dr. Jacqueline Major and collaborators investigated predictors of prostate cancer (CaP) using a validated postoperative nomogram and the association with obesity.

The study cohort consisted of 1,220 men who underwent radical prostatectomy at four centers in southern California between 2000 and 2008. Clinical and pathologic data was assessed and progression-free probabilities (PFP) derived using the 10-year postoperative Kattan nomogram. The 10-year PFP and association with obesity were evaluated using multivariable logistical regression analysis.

At time of RP, mean patient age was 62 years and 23% had a family history of CaP. Mean BMI was 27.7kg/m2 and 305 men had a BMI >30kg/m2 (obese). Median PSA was 5.8ng/ml and over half of patients had a Gleason score ≥7. Over 20% of patients had extra-prostatic extension and 27% had positive surgical margins. Obese patients had higher Gleason scores, higher PSA levels, and positive surgical margins. The researchers divided patients into quartiles based on postoperative nomogram 10-year PFP. A larger proportion of obese patients had PFP values in the lower two quartiles. The proportion of obese men who had PFP values below the median (a worse prediction) was significantly higher than the proportion of non-obese subjects (57.4 vs. 47.9). Men with Gleason score ≥7 were 1.44 times more likely to be obese than those with Gleason score <7. The odds of obesity increased by a factor of 1.24 for every 1ng/ml increase in PSA. Obesity was not associated with pathologic stage, surgical margins status, extra-capsular extension, seminal vesicle invasion, and lymph node involvement. They found a significant inverse association between obesity and PFP nomogram predictions; the odds of obesity decreased by a factor of 0.87 for every 20% increase in PFP. This means that obese patients were more likely to have CaP progression.

Major JM, Klonoff-Cohen HS, Pierce JP, Slymen DJ, Saltzstein SL, Macera CA, Mercola D, Kattan MW



PLoS One. 2011 Feb 24;6(2):e17382

PubMed Abstract
PMID: 21390220

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