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Obesity at diagnosis and prostate cancer prognosis and recurrence risk following primary treatment by radical prostatectomy

Cancer Epidemiology, Biomarkers & Prevention Oct 09, 2019

Langlais CS, Cowan JE, Neuhaus J, et al. - Since the link between obesity at diagnosis and prostate cancer progression is not clear, researchers examined men registered in CaPSURE who had radical prostatectomy between 1995 and 2017, to determine the link between BMI (18.5–< 25, 25–< 30, 30–< 35, ≥ 35 kg/m2) and prognostic risk at diagnosis, compare the concordance between prognostic risk evaluated at diagnostic biopsy vs pathologic risk evaluated at surgery across BMI categories, and to find out the link between obesity and prostate cancer recurrence and all-cause mortality. They found a link of obesity with higher prognostic risk at time of diagnosis and upward reclassification of disease between biopsy and surgery, driven by alteration in tumor stage. The conflicting proof concerning obesity's impact on prostate cancer progression may be explained in part by residual confounding. In larger men, evaluating T-stage by means of digital rectal exam may be complicated, potentially influencing clinical treatment decisions. A strong link with all-cause mortality showed that an improved overall survival may still be achieved in relation to a healthier BMI at diagnosis.
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