We were fortunate to have access to a large cohort of patients undergoing transrectal ultrasound-guided prostate biopsy for cancer suspicion at Princess Margaret Hospital. Almost all studies were performed by a single radiologist, allowing us to retrospectively review the systematically stored images and obtain peri-prostatic fat measurements. We were thus able to construct a database to compare our study variable (peri-prostatic fat measurement) to the outcome (prostate biopsy pathology). We were also able to control for various confounding parameters using multivariable analyses.
Prior studies were able to demonstrate that peri-prostatic quantity is associated with higher grade disease in prostate cancer patients, however they could not establish a link with new prostate cancer diagnosis. Our group is the first to look at peri-prostatic fat thickness in a population of patients not yet diagnosed with prostate cancer. This has allowed us to reveal peri-prostatic fat quantity as a risk factor for the diagnosis of prostate cancer and as a risk factor for high-grade disease upon prostate biopsy. Specifically, upon adjusting for other variables, the odds of detecting any prostate cancer and high-grade prostate cancer increase 12% and 20%, respectively, for each millimeter increase in peri-prostatic fat thickness. Moreover, our study suggests that peri-prostatic fat measurements constitute a distinct parameter, rather than a surrogate for total body adiposity.
At least two key issues arise from the findings of this study. First is whether peri-prostatic fat measurements may have a clinical role in the future in prostate cancer risk assessment by complementing other well-established parameters. Further prospective studies are needed on this topic. Second, one must wonder what are the potential cellular and molecular mechanisms underlying the clinical association described in our study. Although still preliminary, we have begun to study the relationship between peri-prostatic fat thickness and adipokines, which may allow us to infer which signaling molecules may play a more important role.
Written by:
Bimal Bhindi as part of Beyond the Abstract on UroToday.com. This initiative offers a method of publishing for the professional urology community. Authors are given an opportunity to expand on the circumstances, limitations etc... of their research by referencing the published abstract.
Division of Urology, Department of Surgical Oncology
Princess Margaret Hospital
University Health Network
610 University Ave 3-130
Toronto, Ontario, Canada, M5G 2M9
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