부산대학교 도서관

Background Little is known about the relationship between preoperative body mass index and need for adjuvant radiation therapy (RT) following radical prostatectomy. The goal of this study was to evaluate the utility of body mass index in predicting adverse clinical outcomes which require adjuvant RT among men with organ-confined prostate cancer (PCa). Methods We used a prospective cohort of 1,170 low-intermediate PCa risk men who underwent radical prostatectomy and evaluated the effect of body mass index on adverse pathologic features and freedom from biochemical failure (FFbF). Clinical and pathologic variables were compared across the body mass index groups using an analysis of variance model for continuous variables or [chl].sup.2 for categorical variables. Factors related to adverse pathologic features were examined using logistic regression models. Time to biochemical recurrence was compared across the groups using a log-rank survivorship analysis. Multivariable analysis predicting biochemical recurrence was conducted with a Cox proportional hazards model. Results Patients with elevated body mass index (defined as body mass index [greater than or equai to]25 kg/m.sup.2) had greater extraprostatic extension (p = 0.004), and positive surgical margins (p = 0.01). Elevated body mass index did not correlate with preoperative risk groupings (p = 0.94). However, when compared with non-obese patients (body mass index Conclusions Body mass index of [greater than or equai to]30 kg/m.sup.2 is independently associated with adverse pathologic features, which is an indicator for additional RT, particularly in patients with low-intermediate risk disease. Future studies may determine if this select group of patients may be best treated with definitive RT to reduce toxicity from additional RT following radical prostatectomy. We propose including body mass index in clinical decision-making for appropriate treatment recommendation for patients with low-intermediate risk PCa. Keywords: Body mass index, Biochemical failure, Tumor pathology, Prostate cancer treatment
Author(s): Kosj Yamoah[sup.1] , Charnita M. Zeigler-Johnson[sup.2] , Abra Jeffers[sup.3] , Bruce Malkowicz[sup.4] , Elaine Spangler[sup.4] , Jong Y. Park[sup.1] , Alice Whittemore[sup.3] and Timothy R. Rebbeck[sup.5] Background Obesity, one [...]