Some prior studies have suggested a relationship between obesity and adverse pathologic features on prostate biopsy and have suggested that obese patients may ber at higher risk for prostate cancer-related death after radical prostatectomy. However, other studies have been unable to demonstrate any relationship between obesity and clinical risks from prostate cancer.
Bittner et al. have now investigated the potential relationship between body mass index (BMI) and prostate cancer pathology in a group of 244 patients who received saturation biopsies using a transperineal template-guided mapping biopsy (TTMB) method between January 2005 and January 2008. In looking at the data from this study it is very important to understand that all the patients given this form of saturation biopsy had already received one or more negative traditional biopsies. All patients also had to have a persistently elevated PSA and/or a diagnosis of ASAP and/or a diagnosis of high-grade prostatic intraepithelial neoplasia (HG-PIN).
The authors divided the study population into 4 different groups based on their BMI: < 25 (normal), 25-29.9 (overweight), 30-34.9 (obese), and ≥ 35 kg/m2 (severely obese), and compared the results of the biopsy data between the groups. Their analysis showed that:
Pre-TTMB clinical parameters, including PSA and prostate volume, were not significantly different between the groups.
112/244 patients (45.9 poercent), were diagnosed with prostate adenocarcinoma on TTMB.
There was no difference in the rate of cancer detection between the different groups.
BMI did not correlate with Gleason score or percent of positive biopsy cores among the patients actually diagnosed with prostate cancer.
There were no statistically significant differences in cancer location among the patients diagnosed with cancer in ther four BMI groups.
The authors conclude that, “In this study, obesity did not predispose toward higher Gleason score, larger cancer volume, or geographic cancer distribution on repeat biopsy with TTMB.”
However, it is hard to know exactly what to make of these data simply because this was hardly a “representative” group of patients. All these men not only had to meet the study criteria, they also had selected the opportunity to undergo TTMB, which is still not a commonly performed type of biopsy, implying that these patients were particularly concerned about their risk for some reason. In addition, because they were all biopsied at one specific, research-oriented center, they may have been other factors that influenced their decision to undergo such a biopsy.
Some prior studies have suggested a relationship between obesity and adverse pathologic features on prostate biopsy and have suggested that obese patients may ber at higher risk for prostate cancer-related death after radical prostatectomy. However, other studies have been unable to demonstrate any relationship between obesity and clinical risks from prostate cancer.
Bittner et al. have now investigated the potential relationship between body mass index (BMI) and prostate cancer pathology in a group of 244 patients who received saturation biopsies using a transperineal template-guided mapping biopsy (TTMB) method between January 2005 and January 2008. In looking at the data from this study it is very important to understand that all the patients given this form of saturation biopsy had already received one or more negative traditional biopsies. All patients also had to have a persistently elevated PSA and/or a diagnosis of ASAP and/or a diagnosis of high-grade prostatic intraepithelial neoplasia (HG-PIN).
The authors divided the study population into 4 different groups based on their BMI: < 25 (normal), 25-29.9 (overweight), 30-34.9 (obese), and ≥ 35 kg/m2 (severely obese), and compared the results of the biopsy data between the groups. Their analysis showed that:
The authors conclude that, “In this study, obesity did not predispose toward higher Gleason score, larger cancer volume, or geographic cancer distribution on repeat biopsy with TTMB.”
However, it is hard to know exactly what to make of these data simply because this was hardly a “representative” group of patients. All these men not only had to meet the study criteria, they also had selected the opportunity to undergo TTMB, which is still not a commonly performed type of biopsy, implying that these patients were particularly concerned about their risk for some reason. In addition, because they were all biopsied at one specific, research-oriented center, they may have been other factors that influenced their decision to undergo such a biopsy.