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Klinische und histopathologische Parameter des Prostatakarzinoms

Einfluss anthropometrischer Indizes

Clinical and histopathological parameters of prostate cancer

Influence of anthropometric indices

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Zusammenfassung

Hintergrund

Das Fettgewebe wird immer mehr als endokrin aktives Organ betrachtet und könnte auch Einfluss auf die Entstehung und Progression des Prostatakrebses (PCA) haben. Eine ungünstige Körperfettverteilung bei Adipositas ist als Risikofaktor für kardiovaskuläre Erkrankungen gesichert. Der „Body Mass Index“ (BMI) als Parameter für Adipositas erfasst die Körperfettverteilung allerdings nicht.

Fragestellung

Ziel der Arbeit ist es, anthropometrische Indizes, die eine bessere Aussage über die Körperfettverteilung ermöglichen, auf ihren Zusammenhang mit klinischen und histopathologischen Parametern beim PCA zu untersuchen.

Patienten und Methoden

Bei Patienten vor radikaler Prostatektomie erfolgte die Messung von Körpergröße, Gewicht, Bauch- (BU) und Hüftumfang. Daraus wurden BMI, „waist-to-hip ratio“ (WHR) und „waist-to-height ratio“ (WHtR) berechnet. Ein möglicher Zusammenhang von Körpermaßen, anthropometrischen Indizes mit histopathologischen, laborchemischen und klinischen Befunden wurde statistisch uni- und multivariabel untersucht.

Ergebnisse

Im Zeitraum von März 2011 bis März 2013 wurden 668 Patienten erfasst. Die Prävalenz der Adipositas definiert als BMI ≥ 30, WHR ≥ 1 oder WHtR ≥ 0,6 lag bei 22,8 %, 50,6 % bzw. 30,2 %. In der univariaten Analyse korrelierten BU und WHtR ≥ 0,6 mit prostataspezifischem Antigen (PSA) und Tumorvolumen (TV, p < 0,05). BU und WHtR waren unabhängige Prädiktoren eines TV ≥ 2,1 cm2 (p < 0,05) und ein WHtR ≥ 0,6 war unabhängiger Prädiktor eines TV ≥ 2,1 cm2 [p < 0,018; relatives Risiko (RR) 1,506; 95 %-Konfidenzintervall (-KI) 1,072–2,115].

Schlussfolgerung

Unabhängig vom verwendeten anthropometrischen Index scheint ein Zusammenhang von Adipositas und höherem Tumorvolumen des PCA zu bestehen. Ob anthropometrische Indizes, insbesondere die WHtR, prognostische Bedeutung haben, muss im Follow-up geklärt werden.

Abstract

Background

Adipose tissue is increasingly considered as an endocrinal active organ and may have an influence on the development and progression of prostate cancer. Adverse body fat distribution, considered a risk factor for cardiovascular disease, is not reflected by the body mass index (BMI).

Objective

The purpose of this work was to assess anthropometric indices which provide a better estimate of body fat distribution and to evaluate their association with clinical and histopathological parameters of prostate cancer.

Patients and methods

In patients scheduled for radical prostatectomy between March 2011 and March 2013, height, weight, waist circumference (WC) and hip circumference were measured, then the BMI, waist-to-hip ratio (WHR) and waist-to-height ratio (WHtR) were calculated. The relationships between anthropometric measures and indices and clinical and histopathological features of PCA were evaluated with uni- and multivariate analyses.

Results

In 668 patients available for evaluation, obesity rates were 22.8 %, 50.6% and 30.2 % as defined by BMI ≥ 30, WHR ≥ 1 and WHtR ≥ 0.6, respectively. On univariate analysis, WC and WHtR ≥ 0.6 correlated with tumor volume (TV) > 2.1 cm2 (p < 0.05), respectively. WC and WHtR were independent predictors of a TV ≥ 2.1 cm2 (p < 0.05) and a WHtR ≥ 0.6 was an independent predictor of a TV ≥ 2.1 cm2 (p < 0.018, risk ratio 1.506, 95 % confidence interval 1.072–2.115).

Conclusion

In general a higher degree of adiposity seems to correlate with a higher tumor volume. Whether anthropometric indices have prognostic impact needs to be clarified during follow-up.

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Literatur

  1. Ahima RS, Lazar MA (2013) The health risk of obesity – better metrics imperative. Science 341:856–858

    Article  CAS  PubMed  Google Scholar 

  2. Allott EH, Masko EM, Freedland SJ (2013) Obesity and prostate cancer: weighing the evidence. Eur Urol 63:800–809

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  3. Banez LL, Hamilton RJ, Partin AW et al (2007) Obesity-related plasma hemodilution and PSA concentration among men with prostate cancer. JAMA 298:2275–2280

    Article  PubMed  Google Scholar 

  4. Berrington De Gonzalez A, Hartge P, Cerhan JR et al (2010) Body-mass index and mortality among 1.46 million white adults. N Engl J Med 363:2211–2219

    Article  Google Scholar 

  5. Calle EE, Kaaks R (2004) Overweight, obesity and cancer: epidemiological evidence and proposed mechanisms. Nature reviews. Cancer 4:579–591

    CAS  PubMed  Google Scholar 

  6. Calle EE, Rodriguez C, Walker-Thurmond K et al (2003) Overweight, obesity, and mortality from cancer in a prospectively studied cohort of U.S. adults. N Engl J Med 348:1625–1638

    Article  PubMed  Google Scholar 

  7. Capitanio U, Suardi N, Briganti A et al (2012) Influence of obesity on tumour volume in patients with prostate cancer. BJU Int 109:678–684

    Article  PubMed  Google Scholar 

  8. Chang IH, Ahn SH, Han JH et al (2009) The clinical significance in healthy men of the association between obesity related plasma hemodilution and tumor marker concentration. J Urol 181:567–573

    Article  PubMed  Google Scholar 

  9. Charlson ME, Pompei P, Ales KL et al (1987) A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis 40:373–383

    Article  CAS  PubMed  Google Scholar 

  10. De Nunzio C, Aronson W, Freedland SJ et al (2012) The correlation between metabolic syndrome and prostatic diseases. Eur Urol 61:560–570

    Article  Google Scholar 

  11. Freedland SJ, Banez LL, Sun LL et al (2009) Obese men have higher-grade and larger tumors: an analysis of the duke prostate center database. Prostate Cancer Prostatic Dis 12:259–263

    Article  CAS  PubMed  Google Scholar 

  12. Ghaem Maralani H, Tai BC, Wong TY et al (2013) Metabolic syndrome and mortality in the elderly: a time-dependent association. Diabetes Res Clin Pract 99:209–216

    Article  Google Scholar 

  13. Hoda MR, Mohammed N, Theil G et al (2012) Obesity and prostate cancer. Role of adipocytokines and clinical implications. Urologe A 51:1253–1260

    Article  CAS  PubMed  Google Scholar 

  14. International WCRF, Research AIFC (2007) Body composition, growth and developement. In: Food, nutrition, physical activity, and the prevention of cancer: a global perspective. International WCRF, Washington DC, S 210–242

  15. Isbarn H, Jeldres C, Budaus L et al (2009) Effect of body mass index on histopathologic parameters: results of large European contemporary consecutive open radical prostatectomy series. Urology 73:615–619

    Article  PubMed  Google Scholar 

  16. Koster A, Leitzmann MF, Schatzkin A et al (2008) Waist circumference and mortality. Am J Epidemiol 167:1465–1475

    Article  PubMed  Google Scholar 

  17. Lean ME, Han TS, Morrison CE (1995) Waist circumference as a measure for indicating need for weight management. BMJ 311:158–161

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  18. Loeb S, Yu X, Nadler RB et al (2007) Does body mass index affect preoperative prostate specific antigen velocity or pathological outcomes after radical prostatectomy? J Urol 177:102–106

    Article  PubMed  Google Scholar 

  19. Mcneal JE, Redwine EA, Freiha FS et al (1988) Zonal distribution of prostatic adenocarcinoma. Correlation with histologic pattern and direction of spread. Am J Surg Pathol 12:897–906

    Article  CAS  PubMed  Google Scholar 

  20. Mitchell CR, Umbreit EC, Rangel LJ et al (2011) Does body mass index „dilute“ the predictive property of prostate-specific antigen for tumor volume at radical prostatectomy? Urology 78:868–872

    Article  PubMed  Google Scholar 

  21. Napolitano A, Miller SR, Murgatroyd PR et al (2008) Validation of a quantitative magnetic resonance method for measuring human body composition. Obesity 16:191–198

    Article  PubMed  Google Scholar 

  22. Okorodudu DO, Jumean MF, Montori VM et al (2010) Diagnostic performance of body mass index to identify obesity as defined by body adiposity: a systematic review and meta-analysis. Int J Obes 34:791–799

    Article  CAS  Google Scholar 

  23. Perez-Hernandez AI, Catalan V, Gomez-Ambrosi J et al (2014) Mechanisms linking excess adiposity and carcinogenesis promotion. Front Endocrinol 5:65

    Google Scholar 

  24. Pischon T, Boeing H, Hoffmann K et al (2008) General and abdominal adiposity and risk of death in Europe. N Engl J Med 359:2105–2120

    Article  CAS  PubMed  Google Scholar 

  25. Pischon T, Boeing H, Weikert S et al (2008) Body size and risk of prostate cancer in the European prospective investigation into cancer and nutrition. Cancer Epidemiol Biomarkers Prev 17:3252–3261

    Article  PubMed  Google Scholar 

  26. Romero-Corral A, Somers VK, Sierra-Johnson J et al (2008) Accuracy of body mass index in diagnosing obesity in the adult general population. Int J Obes 32:959–966

    Article  CAS  Google Scholar 

  27. Schneider HJ, Friedrich N, Klotsche J et al (2010) The predictive value of different measures of obesity for incident cardiovascular events and mortality. J Clin Endocrinol Metab 95:1777–1785

    Article  CAS  PubMed  Google Scholar 

  28. Shafer KJ, Siders WA, Johnson LK et al (2009) Validity of segmental multiple-frequency bioelectrical impedance analysis to estimate body composition of adults across a range of body mass indexes. Nutrition 25:25–32

    Article  PubMed  Google Scholar 

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Einhaltung ethischer Richtlinien

Interessenkonflikt: B. Löppenberg, F. Roghmann, M. Brock, C. von Bodmann, C.J. Michels, J. Noldus und J. Palisaar geben an, dass kein Interessenkonflikt besteht. Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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Authors and Affiliations

  1. Klinik für Urologie, Marien-Hospital Herne, Klinikum der Ruhr-Universität Bochum, Widumerstraße 8, 44627, Herne, Deutschland

    B. Löppenberg, F. Roghmann, M. Brock, C. von Bodmann, J. Noldus & J. Palisaar

  2. Urologikum Dortmund, Dortmund, Deutschland

    C.J. Michels

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  1. B. Löppenberg
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  2. F. Roghmann
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  3. M. Brock
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  4. C. von Bodmann
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  5. C.J. Michels
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  6. J. Noldus
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  7. J. Palisaar
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Correspondence to B. Löppenberg.

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Löppenberg, B., Roghmann, F., Brock, M. et al. Klinische und histopathologische Parameter des Prostatakarzinoms. Urologe 54, 22–27 (2015). https://doi.org/10.1007/s00120-014-3700-4

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  • DOI: https://doi.org/10.1007/s00120-014-3700-4

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