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Review
. 2011 Apr;4(4):486-501.
doi: 10.1158/1940-6207.CAPR-10-0229. Epub 2011 Jan 13.

Body mass index, prostate cancer-specific mortality, and biochemical recurrence: a systematic review and meta-analysis

Yin Cao  1 , Jing Ma
Affiliations
Review

Body mass index, prostate cancer-specific mortality, and biochemical recurrence: a systematic review and meta-analysis

Yin Cao et al. Cancer Prev Res (Phila). 2011 Apr.

Abstract

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/m(2) 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/m(2) 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/m(2) 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/m(2) 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.

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Figures

Figure 1
Figure 1
Selection of studies for meta-analysis
Figure 2
Figure 2
Figure 2a. Relative risks per 5kg/m2 increase of body-mass index and prostate cancer-specific mortality Abbreviation: CI, confidence interval Figure 2b. Relative risks per 5kg/m2 increase of body-mass index and biochemical recurrence after treatment Abbreviation: RP, radical prostatectomy; RT, radiation therapy, including brachytherapy, external beam radiation therapy and radiation therapy with androgen suppression therapy; CI, confidence interval.
Figure 2
Figure 2
Figure 2a. Relative risks per 5kg/m2 increase of body-mass index and prostate cancer-specific mortality Abbreviation: CI, confidence interval Figure 2b. Relative risks per 5kg/m2 increase of body-mass index and biochemical recurrence after treatment Abbreviation: RP, radical prostatectomy; RT, radiation therapy, including brachytherapy, external beam radiation therapy and radiation therapy with androgen suppression therapy; CI, confidence interval.
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