Association of obesity with tumor characteristics and treatment failure of prostate cancer in African-American and European American men
Association of obesity with tumor characteristics and treatment failure of prostate cancer in African-American and European American men
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DOI：
10.1016/j.juro.2007.07.021
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发表时间：
2007-11-01
影响因子：
6.6
通讯作者：
Rebbeck, T. R.
中科院分区：
文献类型：
--
作者：
Spangler, E.;Zeigler-Johnson, C. M.;Rebbeck, T. R.
目的：体重指数对前列腺癌的肿瘤特征和治疗失败的影响在不同的种族中还没有很好的了解。我们评估了1995至2004年间接受前列腺癌根治术的非裔美国人和欧洲裔美国人患者的体重指数对肿瘤组织病理学特征和生化无复发生存率的影响。材料和方法：共有924名患者进行研究，以评估肥胖男性(体重指数大于30)与非肥胖男性在手术前后的肿瘤特征或生化无复发生存率是否有所不同。根据年龄、术前前列腺特异性抗原、肿瘤分期和种族对784名欧洲裔美国人和140名非洲裔美国人的失败时间模型进行了分析。结果：平均随访时间42个月，中位随访时间36个月。非洲裔美国男性的肥胖程度明显高于欧洲裔美国男性。非裔美国人的平均体重指数为29.0，欧洲裔美国人的平均体重指数为28.1%(p=0.003)。非洲裔美国男性(OR 2.30，95%CI 1.04-5.1)更有可能在最终病理上有更高的肿瘤分期。在非裔美国人男性中，肥胖是导致生化失败的危险因素(调整后的危险比为5.49，95%可信区间为2.16-13.9)，而在欧洲裔美国人中则不是(HR1.41，95%可信区间为0.96-2.08)，且差异有统计学意义(交互作用0.036的p值)。结论：肥胖与较差的肿瘤预后特征和降低的生化无复发生存率有关，在非裔美国人中尤其如此。这些数据表明，与其他种族和民族相比，肥胖可能在一定程度上解释了非裔美国人患前列腺癌的预后较差的原因。
Purpose: The impact of body mass index on tumor characteristics and treatment failure in prostate cancer is not well understood in diverse ethnic groups. We evaluated the effect of body mass index in African-American and European American patients from a radical prostatectomy cohort between 1995 and 2004 with regard to tumor histopathological characteristics and biochemical relapse-free survival.Materials and Methods: A total of 924 patients were studied to evaluate whether obese men (body mass index greater than 30) had different preoperative and postoperative tumor characteristics or biochemical relapse-free survival compared to nonobese men. There were 784 European American and 140 African-American patients analyzed using failure time models, adjusted for age, preoperative prostate specific antigen, tumor stage and race.Results: Mean and median followup was 42 and 36 months, respectively. African-American men were significantly more obese than European American men. Mean body mass index was 29.0 in African-American and 28.1 in European American men (p = 0.003). African-American men (OR 2.30, 95% CI 1.04-5.1) were more likely to have higher tumor stage on final pathology. Obesity was a risk factor for biochemical failure in African-American men (adjusted hazard ratio 5.49, 95% CI 2.16-13.9) but not in European American men (HR 1.41, 95% CI 0.96-2.08), and this difference was statistically significant (p value for interaction 0.036).Conclusions: Obesity is associated with poorer tumor prognostic characteristics and decreased biochemical relapse-free survival, particularly in African-American men. These data suggest that obesity may in part explain the poorer prostate cancer prognosis seen in African-American men compared to other racial and ethnic groups.