Does Body Mass Index Influence the Outcomes After Surgery for Locally Advanced Prostate Cancer?

Introduction: A higher body mass index (BMI) has been correlated with worse outcome after radical prostatectomy (RP), but this observation has been mainly noticed in clinically localized disease. The objective of this study is to analyze the relationship between BMI and outcome of surgery for clinical unilateral T3a (cT3a) prostate cancer. Patients and Methods: Two hundred patients with cT3a prostate cancer underwent RP between 1987 and 2004. The BMI of each patient was recorded before surgery. Patients were divided into 2 groups: BMI <25 and 25. The Cox proportional hazard analysis was used to study the differences in outcome between these two groups. Results: The mean age was 63.3 years (range 41 to 79). The mean follow-up was 70.6 months (range 7 to 177). Ninetythree patients had BMI <25, and 107 patients had BMI 25. There were no significant differences between BMI <25 and 25 in the incidence of node positive disease (p=0.22) and margin status (p=0.48). Neither were there significant differences between these two groups in pre-operative PSA (p=0.15) and cancer volume (p=0.07). In the Cox proportional hazard analysis, BMI was a significant predictor in clinical progression free survival (CPFS). Conclusion: BMI has been correlated with worse outcome after RP in clinically localized disease. We could confirm this observation in CPFS of cT3a disease. However, while oncological outcomes seem to differ, this type of surgery may be very demanding and postoperative short-term morbidity may also be higher in patients with BMI 25.