Kathryn Barry

Ph.D., M.P.H.

University of Maryland, Baltimore

Assistant Professor

PLCO (Learn more about this study)

PLCO-455

Feb 28, 2019

The role of BMI in upgrading and upstaging of men with clinically localized prostate cancer

Radical prostatectomy is one of the mainstays of treatment for localized prostate cancer, in addition to radiation therapy. Upgrading and upstaging of disease is not an uncommon phenomenon at radical prostatectomy, likely explained by the biological course of the disease and/or by sampling error of biopsy. Biological mechanisms associated with obesity such as deregulation of the insulin axis, sex hormone secretion, and oxidative stress are thought to play a role in prostate cancer pathogenesis and progression (Bandini et al., 2017). Therefore, body mass index (BMI) may be a factor that can differentiate men who are more likely to be upgraded and upstaged on radical prostatectomy from those whose grade and stage would remain unchanged. An association between obesity and an increased risk of prostate cancer upstaging/upgrading was reported in a single-center study (Ploussard et al., 2012), but larger, confirmatory studies are needed.

Using data from the Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial, we aim to estimate the proportion of prostate cancer patients with localized disease who are upstaged and upgraded at radical prostatectomy and to evaluate whether this proportion varies by BMI.