Obesity in prostate cancer survivors may increase mortality. Better characterization of this effect may allow better counseling on obesity as a targetable lifestyle factor to reduce mortality in prostate cancer survivors. The purpose of this study was to determine whether pre- and post-diagnostic obesity and weight change affect all-cause mortality, cardiovascular disease specific mortality, and prostate cancer specific mortality in patients with nonmetastatic prostate cancer.
We performed a retrospective cohort analysis of 5,077 patients diagnosed with localized prostate cancer from 1997 to 2017 with median follow-up of 15.5 years. The Utah Population Database linked to the Utah Cancer Registry was used to identify patients at a variety of treatment centers.
Pre-diagnosis obesity was associated with a 62% increased risk of cardiovascular disease specific mortality and a 34% increased risk of all-cause mortality (HR 1.62, 95% CI 1.05-2.50; HR 1.34, 95% CI 1.07-1.67, respectively). Post-diagnosis obesity increased the risk of cardiovascular disease specific mortality (HR 1.83, 95% CI 1.31-2.56) and all-cause mortality (HR 1.37, 95% CI 1.16-1.64) relative to non-obese men. We found no association between pre-diagnostic obesity or post-diagnostic weight gain and prostate cancer specific mortality.
Our study strengthens the conclusion that pre-, post-diagnostic obesity and weight gain increase cardiovascular disease and all-cause mortality but not prostate cancer specific mortality compared to healthy weight men. An increased emphasis on weight management may improve mortality for prostate cancer survivors who are obese.
Clinical genitourinary cancer. 2024 Feb 17 [Epub ahead of print]
Kassandra Dindinger-Hill, Siqi Hu, Atticus Hickman, Mouneeb Choudry, Jeffrey Vehawn, John Snyder, Vikrant Deshmukh, Michael Newman, Ankita Date, Carlos Galvao, Manish Kohli, Brock O'Neil, Bogdana Schmidt, Christopher Dechet, Mia Hashibe, Alejandro Sanchez
Huntsman Cancer Institute, Salt Lake City, UT., Huntsman Cancer Institute, Salt Lake City, UT; Division of Public Health, Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT., Davidson College, Davidson, NC., Department of Urology, Mayo Clinic, Phoenix, AZ., Intermountain Healthcare, Salt Lake City, UT., University of Utah Health Sciences Center, Salt Lake City, UT., Pedigree and Population Resource, Population Sciences, Huntsman Cancer Institute, Salt Lake City, UT., Huntsman Cancer Institute, Salt Lake City, UT; Division of Oncology, Department of Medicine, University of Utah, Salt Lake City, UT., Huntsman Cancer Institute, Salt Lake City, UT. Electronic address: .