Body Mass Index and Weight Change in Men with Prostate Cancer: Progression and Mortality.

270 Background: Body mass index (BMI) at diagnosis is associated with increased risk of fatal prostate cancer, but the link between BMI at mCRPC and cancer progression is less clear. Cachexia, often defined as involuntary weight loss > 5% over 6 months, is common in advanced cancers. The goal of this study was to examine the link between BMI at mCRPC and weight change as it relates to cancer progression, the outcomes of survival, and treatment use in a single-institution setting. Methods: 58 mCRPC patients treated at Tulane Hospital were identified, 41 of whom had an overweight BMI at mCRPC (BMI > 25) and 17 with normal BMI at mCRPC (BMI < 25). All patients had a confirmed prostate cancer death. Survival, treatment history, and percent weight change were compared according to BMI status. Rate of percent weight change was defined as the change in weight per day, from date of mCRPC diagnosis to the last treatment stop date or death date (“mCRPC days”). Linear regression, overall survival (OS), and nonparametric analyses were performed. Results: There was no significant difference between the normal and overweight BMI groups in overall survival, from date of diagnosis to death (median = 1835 days vs. 2710 days respectively). Additionally, the difference in survival from mCRPC to death was not statistically significant (median = 630 days vs. 799 days, p = 0.115). Use of Taxotere was not significantly different (47% vs. 68% respectively); however, overweight patients (n = 28) more likely received Abiraterone than normal BMI patients (n = 2) (p-value = 0.0001). The rate of percent weight change was significantly different for normal and overweight patients (mean = –0.050%/day vs. –0.019%/day, p = 0.003). Linear regression analysis showed that mCRPC days had a significant effect on percent weight change (p = 0.0109), and this effect was not significantly different between BMI groups (p = 0.6991). Conclusions: Survival after mCRPC was not significantly different between BMI groups. We observed a significant effect of mCRPC days on percent weight change, with a similar effect for both BMI groups. This outcome is expected, as more time would allow for greater weight changes to occur. Larger studies are needed to fully evaluate these observations.

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Abstract LB-179: Pre- and post-diagnosis body mass index, weight change, and prostate cancer-specific mortality among prostate cancer survivors in the US

10.1158/1538-7445.am2019-lb-179 ◽

2019 ◽

Author(s):

Alyssa N. Troeschel ◽

Eric J. Jacobs ◽

W. Dana Flanders ◽

Victoria L. Stevens ◽

Terryl J. Hartman ◽

...

Keyword(s):

Prostate Cancer ◽

Body Mass Index ◽

Cancer Survivors ◽

Body Mass ◽

Weight Change ◽

Prostate Cancer Survivors ◽

The Us ◽

Specific Mortality ◽

Cancer Specific Mortality ◽

Index Weight

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Weight change, obesity and risk of prostate cancer progression among men with clinically localized prostate cancer

International Journal of Cancer ◽

10.1002/ijc.30803 ◽

2017 ◽

Vol 141 (5) ◽

pp. 933-944 ◽

Cited By ~ 18

Author(s):

Barbra A. Dickerman ◽

Thomas U. Ahearn ◽

Edward Giovannucci ◽

Meir J. Stampfer ◽

Paul L. Nguyen ◽

...

Keyword(s):

Prostate Cancer ◽

Cancer Progression ◽

Weight Change ◽

Localized Prostate Cancer ◽

Prostate Cancer Progression

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Abstract LB-179: Pre- and post-diagnosis body mass index, weight change, and prostate cancer-specific mortality among prostate cancer survivors in the US

10.1158/1538-7445.sabcs18-lb-179 ◽

2019 ◽

Author(s):

Alyssa N. Troeschel ◽

Eric J. Jacobs ◽

W. Dana Flanders ◽

Victoria L. Stevens ◽

Terryl J. Hartman ◽

...

Keyword(s):

Prostate Cancer ◽

Body Mass Index ◽

Cancer Survivors ◽

Body Mass ◽

Weight Change ◽

Prostate Cancer Survivors ◽

The Us ◽

Specific Mortality ◽

Cancer Specific Mortality ◽

Index Weight

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Postdiagnosis Body Mass Index, Weight Change, and Mortality From Prostate Cancer, Cardiovascular Disease, and All Causes Among Survivors of Nonmetastatic Prostate Cancer

Journal of Clinical Oncology ◽

10.1200/jco.19.02185 ◽

2020 ◽

Vol 38 (18) ◽

pp. 2018-2027 ◽

Cited By ~ 3

Author(s):

Alyssa N. Troeschel ◽

Terryl J. Hartman ◽

Eric J. Jacobs ◽

Victoria L. Stevens ◽

Ted Gansler ◽

...

Keyword(s):

Prostate Cancer ◽

Cardiovascular Disease ◽

Body Mass Index ◽

Weight Gain ◽

Body Mass ◽

Weight Change ◽

Cox Proportional Hazards ◽

Healthy Weight ◽

All Cause Mortality

PURPOSE To investigate the association of postdiagnosis body mass index (BMI) and weight change with prostate cancer–specific mortality (PCSM), cardiovascular disease–related mortality (CVDM), and all-cause mortality among survivors of nonmetastatic prostate cancer. METHODS Men in the Cancer Prevention Study II Nutrition Cohort diagnosed with nonmetastatic prostate cancer between 1992 and 2013 were followed for mortality through December 2016. Current weight was self-reported on follow-up questionnaires approximately every 2 years. Postdiagnosis BMI was obtained from the first survey completed 1 to < 6 years after diagnosis. Weight change was the difference in weight between the first and second postdiagnosis surveys. Deaths occurring within 4 years of the follow-up were excluded to reduce bias from reverse causation. Analyses of BMI and weight change included 8,330 and 6,942 participants, respectively. RESULTS Postdiagnosis BMI analyses included 3,855 deaths from all causes (PCSM, n = 500; CVDM, n = 1,155). Using Cox proportional hazards models, hazard ratios (HRs) associated with postdiagnosis obesity (BMI ≥ 30 kg/m2) compared with healthy weight (BMI 18.5 to < 25.0 kg/m2) were 1.28 for PCSM (95% CI, 0.96 to 1.67), 1.24 for CVDM (95% CI, 1.03 to 1.49), and 1.23 for all-cause mortality (95% CI, 1.11 to 1.35). Weight gain analyses included 2,973 deaths (PCSM, n = 375; CVDM, n = 881). Postdiagnosis weight gain (> 5% of body weight), compared with stable weight (± < 3%), was associated with a higher risk of PCSM (HR, 1.65; 95% CI, 1.21 to 2.25) and all-cause mortality (HR, 1.27; 95% CI, 1.12 to 1.45) but not CVDM. CONCLUSION Results suggest that among survivors of nonmetastatic prostate cancer with largely localized disease, postdiagnosis obesity is associated with higher CVDM and all-cause mortality, and possibly higher PCSM, and that postdiagnosis weight gain may be associated with a higher mortality as a result of all causes and prostate cancer.

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