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The relationship between body-mass index, physical activity, and pathologic and clinical outcomes after radical prostatectomy for prostate cancer

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Abstract

Purpose

We evaluated whether an increased body-mass index (BMI) and decreased physical activity increase the risk of locally advanced or high-risk prostate cancer (PCa) at radical prostatectomy (RP), and treatment failure after surgery.

Methods

Data were collected from the PROCURE Biobank, a prospective cohort of patients with localized PCa undergoing RP in four academic centers in Québec between 2006 and 2013. Treatment failure was defined as biochemical recurrence and/or initiation of secondary, non-adjuvant therapy, and analyzed using the Kaplan–Meier method, log-rank tests, and Cox proportional-hazards models. Uni- and multivariate (ordered) logistic regression was used for time-independent variables.

Results

1813 patients were included. Median follow-up time was 69 months. Patients who reported a lower BMI were generally older, of Asian descent, and physically more active (p < 0.05). Younger, black, and overweight/obese patients reported less physical activity (p < 0.05). In multivariate analyses, a higher BMI increased the risk for locally advanced, high-risk PCa (defined as a pT3, N1 and/or Gleason 8–10 tumor; odds ratio 1.33, p < 0.001), but increased physical activity did not predict high-risk disease (odds ratio 0.84, p = 0.39). Patients with a higher BMI also had a larger prostate at surgery (odds ratio 1.13, p = 0.03). BMI and physical activity were not associated with positive surgical margins or time to treatment failure (p > 0.05).

Conclusions

BMI was an independent predictor for locally advanced, high-risk disease in this cohort of PCa patients undergoing RP, but was unrelated to treatment failure. Physical activity was not related to locally advanced, high-risk PCa or treatment failure.

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Acknowledgements

The authors wish to thank all participating patients in the PROCURE biobank who voluntarily donated time, tissue, biosamples, and data to this study. We would also like to thank Valérie Thibodeau and all our other collaborators at PROCURE and participating hospitals for their dedication to the creation and maintenance of this biobank. Funding for the study and data acquisition was provided by PROCURE Alliance in partnership with the Cancer Research Society of Canada. MW was funded by a Fellowship Award from the Canadian Institutes of Health Research, McGill University, and the department of Urology at the McGill University Health Centre.

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Authors and Affiliations

  1. Department of Urology, McGill University Health Centre, Montreal, QC, Canada

    Michel Wissing, Simone Chevalier, Ginette McKercher, Ana O’Flaherty, Eleonora Scarlata & Armen Aprikian

  2. Department of Oncology, McGill University, 5100 Boulevard de Maisonneuve West, Room 720F, Montreal, QC, H4A 3T2, Canada

    Michel Wissing, Claudie Laprise & Armen Aprikian

  3. Cancer Research Program, McGill University Health Centre - Research Institute, Montreal, QC, Canada

    Simone Chevalier, Ginette McKercher, Saro Aprikian, Eleonora Scarlata & Armen Aprikian

  4. PROCURE, Mont-Royal, Montreal, QC, Canada

    Ginette McKercher & Saro Aprikian

  5. Department of Surgery, Université de Montréal, Montreal, QC, Canada

    Fred Saad

  6. Department of Surgery, Université de Sherbrooke, Sherbrooke, QC, Canada

    Michel Carmel

  7. Department of Surgery, Laval University, Laval, QC, Canada

    Louis Lacombe

  8. Department of Pathology, McGill University, Montreal, QC, Canada

    Fadi Brimo

  9. Department of Pathology and Cell Biology, Université de Montreal, Montreal, QC, Canada

    Mathieu Latour

  10. Department of Pathology, Université de Sherbrooke, Sherbrooke, QC, Canada

    Nadia Ekindi-Ndongo

  11. Department of Pathology, Laval University, Laval, QC, Canada

    Bernard Têtu

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  1. Michel Wissing
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Contributions

MW: project development, data management, data analyses, and manuscript writing. SC: project development, data collection and management, and manuscript editing. GM: data collection and management and manuscript editing. CL: data analyses and manuscript editing. SA: data collection and management and manuscript editing. AO: data collection and management and manuscript editing. ES: data collection and manuscript editing. FS: project development, data collection, and manuscript editing. MC: project development, data collection, and manuscript editing. LL: project development, data collection, and manuscript editing. FB: data collection and manuscript editing. ML: data collection and manuscript editing. NE: data collection and manuscript editing. BT: data collection and manuscript editing. AA: principal investigator, project development, data analyses, and manuscript writing.

Corresponding author

Correspondence to Michel Wissing.

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Funding

Funding was provided by PROCURE Alliance in partnership with the Cancer Research Society of Canada. MW was funded by a Fellowship Award from the Canadian Institutes of Health Research, McGill University, and the department of Urology at the McGill University Health Centre.

Conflict of interest

The authors declare that they have no conflict of interest.

Research involving human participants

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Wissing, M., Chevalier, S., McKercher, G. et al. The relationship between body-mass index, physical activity, and pathologic and clinical outcomes after radical prostatectomy for prostate cancer. World J Urol 37, 789–798 (2019). https://doi.org/10.1007/s00345-018-2457-6

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  • DOI: https://doi.org/10.1007/s00345-018-2457-6

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