Body Mass Index, Prostate Cancer–Specific Mortality, and Biochemical Recurrence: a Systematic Review and Meta-analysis

Increasing evidence suggested obesity, measured by body mass index (BMI), was associated with prostate cancer–specific mortality, and its impact on biochemical recurrence was also inconclusive. We systematically searched MEDLINE, EMBASE, and bibliographies of retrieved studies up to January 5, 2010. We used random-effects meta-analysis to assess the relative risks (RR) of prostate cancer-specific mortality and biochemical recurrence associated with a 5 kg/m2 increase in BMI. Among the six population-based cohort studies in 1,263,483 initially cancer-free men, 6,817 prostate cancer deaths occurred; a 5 kg/m2 increase in BMI was associated with 15% (RR: 1.15, 95% confidence interval (CI): 1.06–1.25, P < 0.01) higher risk of dying of prostate cancer. In the six postdiagnosis survival studies on 18,203 patients with 932 prostate cancer deaths, a 5 kg/m2 increase in BMI was associated with 20% higher prostate cancer–specific mortality (RR: 1.20, 95% CI: 0.99–1.46, P = 0.06). In the sixteen studies which followed 26,479 prostate cancer patients after primary treatment, a 5 kg/m2 increase in BMI was significantly associated with 21% increased risk of biochemical recurrence (RR: 1.21, 95% CI: 1.11–1.31 P < 0.01). Elevated BMI is associated with risk of prostate cancer–specific mortality in prospective cohort studies and biochemical recurrence in prostate cancer patients. Its association with prostate cancer–specific mortality in diagnosed patients needs to be further evaluated. Cancer Prev Res; 4(4); 486–501. ©2011 AACR.

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