Skip to main content

Advertisement

SpringerLink
Log in

Der Einfluss von Adipositas auf urologische Tumorerkrankungen

Influence of obesity on urological malignancies

  • Übersichten
  • Published:
Der Urologe Aims and scope Submit manuscript

Zusammenfassung

Hintergrund

Übergewicht stellt ein wachsendes Problem in unserer Gesellschaft dar. Folglich steigt auch das Interesse, den Einfluss von Adipositas auf urologische Tumorerkrankungen zu verstehen.

Ziel

Adipositas erhöht das Risiko, an einem aggressiven Prostatakarzinom zu erkranken. Eine starke Assoziation zwischen Adipositas und dem Risiko, an einem Nierenzellkarzinomen (NZK) zu erkranken, konnte ebenfalls nachgewiesen werden. Andererseits scheint Adipositas das tumorspezifische Überleben von Patienten mit lokalisierten NZK nach operativer Primärtumorentfernung ebenso zu verlängern wie das Gesamtüberleben von metastasierten Patienten unter Anti-VEGF(R)-gerichteter Behandlung. Der Einfluss des „Body Mass Index“ (BMI) auf Blasentumore wurde bisher hingegen kaum evaluiert. Obwohl eine Assoziation zu existieren scheint, ist eine sichere Aussage aufgrund der wenigen und in Teilen widersprüchlichen Untersuchungen nicht möglich.

Ergebnisse

Ein Einfluss von Übergewicht auf verschiedene urologische Tumorerkrankungen gilt als sicher. Adipositasassoziierte biologische und metabolische Effekte scheinen eine entscheidende Rolle zu spielen. Bis heute bekannte Zusammenhänge werden in dieser Übersichtsarbeit dargestellt.

Abstract

Background

Overweight presents a growing problem in our society; therefore, there is an increasing interest to understand the influence of obesity on urological forms of cancer.

Aim

In prostate cancer the development of a more aggressive phenotype seems to correlate with obesity. In renal cell cancer (RCC) obesity is both, a risk factor for occurrence –and is also associated with an improved tumour-specific survival in patients with organ-confined disease following kidney surgery as well as overall survival of patients with advanced disease receiving VEGF(R)-targeted treatment. In contrast, even though an association between body mass index (BMI) and bladder cancer has been described the role of obesity in bladder cancer remains largely unclear as published data are contradictory.

Results

An update on currently available data focusing on the relationship between obesity and genitourinary malignancies is given in this review; however, basic research which is necessary to define the biological and metabolic effects associated with obesity and which might affect the development and progression of urological cancers, is indicated.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Literatur

  1. Calle EE, Rodriguez C, Walker-Thurmond K, Thun MJ (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 

  2. Stewart SB, Freedland SJ (2011) Influence of obesity on the incidence and treatment of genitourinary malignancies. Urol Oncol 29:476–486

    Article  PubMed  Google Scholar 

  3. MacInnis RJ, English DR (2006) Body size and composition and prostate cancer risk: systematic review and meta-regression analysis. Cancer Causes Control 17:989–1003

    Article  PubMed  Google Scholar 

  4. Fesinmeyer MD, Gulati R, Zeliadt S et al (2009) Effect of population trends in body mass index on prostate cancer incidence and mortality in the United States. Cancer Epidemiol Biomarkers Prev 18:808–815

    Article  PubMed  Google Scholar 

  5. Gong Z, Neuhouser ML, Goodman PJ et al (2006) Obesity, diabetes, and risk of prostate cancer: results from the prostate cancer prevention trial. Cancer Epidemiol Biomarkers Prev 15:1977–1983

    Article  PubMed  Google Scholar 

  6. Rodriguez C, Freedland SJ, Deka A et al (2007) Body mass index, weight change, and risk of prostate cancer in the Cancer Prevention Study II Nutrition Cohort. Cancer Epidemiol Biomarkers Prev 16:63–69

    Article  PubMed  Google Scholar 

  7. Wright ME, Chang SC, Schatzkin A et al (2007) Prospective study of adiposity and weight change in relation to prostate cancer incidence and mortality. Cancer 109:675–684

    Article  PubMed  Google Scholar 

  8. Buschemeyer WC 3rd, Freedland SJ (2007) Obesity and prostate cancer: epidemiology and clinical implications. Eur Urol 52:331–343

    Article  PubMed  Google Scholar 

  9. Freedland SJ, Platz EA (2007) Obesity and prostate cancer: making sense out of apparently conflicting data. Epidemiol Rev 29:88–97

    Article  PubMed  Google Scholar 

  10. Price MM, Hamilton RJ, Robertson CN et al (2008) Body mass index, prostate-specific antigen, and digital rectal examination findings among participants in a prostate cancer screening clinic. Urology 71:787–791

    Article  PubMed  Google Scholar 

  11. Baillargeon J, Pollock BH, Kristal AR et al (2005) The association of body mass index and prostate-specific antigen in a population-based study. Cancer 103:1092–1095

    Article  PubMed  Google Scholar 

  12. Barqawi AB, Golden BK, O’Donnell C et al (2005) Observed effect of age and body mass index on total and complexed PSA: analysis from a national screening program. Urology 65:708–712

    Article  PubMed  Google Scholar 

  13. Fowke JH, Motley SS, Wills M et al (2007) Prostate volume modifies the association between obesity and prostate cancer or high-grade prostatic intraepithelial neoplasia. Cancer Causes Control 18:375–384

    Article  PubMed  Google Scholar 

  14. Gray MA, Delahunt B, Fowles JR et al (2004) Demographic and clinical factors as determinants of serum levels of prostate specific antigen and its derivatives. Anticancer Res 24:2069–2072

    PubMed  Google Scholar 

  15. Ku JH, Kim ME, Lee NK et al (2003) Influence of age, anthropometry, and hepatic and renal function on serum prostate-specific antigen levels in healthy middle-age men. Urology 61:132–136

    Article  PubMed  Google Scholar 

  16. Werny DM, Thompson T, Saraiya M et al (2007) Obesity is negatively associated with prostate-specific antigen in U.S. men, 2001–2004. Cancer Epidemiol Biomarkers Prev 16:70–76

    Article  PubMed  CAS  Google Scholar 

  17. 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 (discussion 106)

    Article  PubMed  Google Scholar 

  18. Hutterer G, Perrotte P, Gallina A et al (2007) Body mass index does not predict prostate-specific antigen or percent free prostate-specific antigen in men undergoing prostate cancer screening. Eur J Cancer 43:1180–1187

    Article  PubMed  CAS  Google Scholar 

  19. Freedland SJ, Humphreys EB, Mangold LA et al (2006) Time to prostate specific antigen recurrence after radical prostatectomy and risk of prostate cancer specific mortality. J Urol 176:1404–1408

    Article  PubMed  Google Scholar 

  20. 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 

  21. Dahle SE, Chokkalingam AP, Gao YT et al (2002) Body size and serum levels of insulin and leptin in relation to the risk of benign prostatic hyperplasia. J Urol 168:599–604

    Article  PubMed  CAS  Google Scholar 

  22. Freedland SJ, Platz EA, Presti JC Jr et al (2006) Obesity, serum prostate specific antigen and prostate size: implications for prostate cancer detection. J Urol 175:500–504

    Article  PubMed  Google Scholar 

  23. Kranse R, Beemsterboer P, Rietbergen J et al (1999) Predictors for biopsy outcome in the European Randomized Study of Screening for Prostate Cancer (Rotterdam region). Prostate 39:316–322

    Article  PubMed  CAS  Google Scholar 

  24. Lowrance WT, Thompson RH, Yee DS et al (2010) Obesity is associated with a higher risk of clear-cell renal cell carcinoma than with other histologies. BJU Int 105:16–20

    Article  PubMed  Google Scholar 

  25. Chow WH, McLaughlin JK, Mandel JS et al (1996) Obesity and risk of renal cell cancer. Cancer Epidemiol Biomarkers Prev 5:17–21

    PubMed  CAS  Google Scholar 

  26. Lindblad P, Wolk A, Bergstrom R et al (1994) The role of obesity and weight fluctuations in the etiology of renal cell cancer: a population-based case-control study. Cancer Epidemiol Biomarkers Prev 3:631–639

    PubMed  CAS  Google Scholar 

  27. Bergstrom A, Hsieh CC, Lindblad P et al (2001) Obesity and renal cell cancer–a quantitative review. Br J Cancer 85:984–990

    Article  PubMed  CAS  Google Scholar 

  28. Bjorge T, Tretli S, Engeland A (2004) Relation of height and body mass index to renal cell carcinoma in two million Norwegian men and women. Am J Epidemiol 160:1168–1176

    PubMed  Google Scholar 

  29. Setiawan VW, Stram DO, Nomura AM et al (2007) Risk factors for renal cell cancer: the multiethnic cohort. Am J Epidemiol 166:932–940

    Article  PubMed  Google Scholar 

  30. Calle EE, Kaaks R (2004) Overweight, obesity and cancer: epidemiological evidence and proposed mechanisms. Nat Rev 4:579–591

    CAS  Google Scholar 

  31. Waalkes S, Merseburger AS, Kramer MW et al (2010) Obesity is associated with improved survival in patients with organ-confined clear-cell kidney cancer. Cancer Causes Control 21:1905–1910

    Article  PubMed  Google Scholar 

  32. Waalkes S, Eggers H, Rustemeier J et al (2011) Overweight is an advantageous prognostic marker in patients with clear cell kidney cancer. Urologe A 50(9):1184–1124

    Google Scholar 

  33. Kamat AM, Shock RP, Naya Y et al (2004) Prognostic value of body mass index in patients undergoing nephrectomy for localized renal tumors. Urology 63:46–50

    Article  PubMed  Google Scholar 

  34. Yu ML, Asal NR, Geyer JR (1991) Later recurrence and longer survival among obese patients with renal cell carcinoma. Cancer 68:1648–1655

    Article  PubMed  CAS  Google Scholar 

  35. Steffens S, Grünwald V, Ringe KI et al (2011) Does obesity influence the prognosis of metastatic renal cell carcinoma in patients treated with vascular endothelial growth factor-targeted therapy? Oncologist 16(11):1565–1571

    Article  PubMed  CAS  Google Scholar 

  36. Golka K, Seidel T, Dietrich H et al (2005) Occupational and non-occupational risk factors in bladder cancer patients in an industrialized area located in former East-Germany. Aktuelle Urol 36:417–422

    Article  PubMed  CAS  Google Scholar 

  37. Koebnick C, Michaud D, Moore SC et al (2008) Body mass index, physical activity, and bladder cancer in a large prospective study. Cancer Epidemiol Biomarkers Prev 17:1214–1221

    Article  PubMed  Google Scholar 

  38. Holick CN, Giovannucci EL, Stampfer MJ, Michaud DS (2007) Prospective study of body mass index, height, physical activity and incidence of bladder cancer in US men and women. Int J Cancer 120:140–146

    Article  PubMed  CAS  Google Scholar 

  39. Maurer T, Maurer J, Retz M et al (2009) Influence of body mass index on operability, morbidity and disease outcome following radical cystectomy. Urol Int 82:432–439

    Article  PubMed  Google Scholar 

  40. Chang SS, Jacobs B, Wells N et al (2004) Increased body mass index predicts increased blood loss during radical cystectomy. J Urol 171:1077–1079

    Article  PubMed  Google Scholar 

  41. Steffens S, Ringe KI, Schroeer K et al (2012) Does overweight influence the prognosis of renal cell carcinoma? Results of a multicenter study. Int J Urol 20(6):585–592

    Article  PubMed  Google Scholar 

  42. Liao LM, Schwartz K, Pollak M (2012) Serum leptin and adiponectin levels and risk of renal cell carcinoma. Obesity (Silver Spring). doi: 10.1002/oby.20138

  43. Bosetti C, Bertuccio P, Chatenoud L et al (2011) Trends in mortality from urologic cancers in Europe, 1970–2008. Eur Urol 60(1):1–15

    Article  PubMed  Google Scholar 

  44. Ferlay J, Steliarova-Foucher E, Lortet-Tieulent J et al (2013) Cancer incidence and moratlity patterns in Europe: estimates for 40 countries in 2012. Eur J Cancer 49(6):1374–1403

    Article  PubMed  CAS  Google Scholar 

  45. Cao Y, Ma J (2011) Body mass index, prostate cancer-specific mortality, and biochemical recurrence: a systematic review and meta-analysis. Cancer Prev Res (Phila) 4:486–501

    Article  Google Scholar 

  46. Allott EH, Masko EM, Freedland SJ (2013) Obesity and prostate cancer: weighing the evidence. Eur Urol 63(5):800–809. doi:10.1016/j.eururo

    Article  PubMed  CAS  Google Scholar 

  47. Keto CJ, Aronson WJ, Terris MK et al (2011) Obesity is associated with castration-resistant disease and metastasis in men treated with androgen deprivation therapy after radical prostatectomy: results from the SEARCH database. BJU Int 110:492–498

    Article  PubMed  Google Scholar 

  48. Schnoeller T, Jentzmik F, Rinnab L et al (2013) Circulating free testosterone is an independent predictor of advanced disease in patients with clinically localized prostate cancer. World J Urol 31:253–259

    Article  PubMed  CAS  Google Scholar 

  49. Lee G, Oh W (2009) Absence of relationship between steroid hormone levels and prostate cancer tumor grade. Urology 73:356–361

    Article  PubMed  Google Scholar 

  50. Roddam AW, Allen NE, Appleby P et al (2008) Insulin-like growth factors, their binding proteins, and prostate cancer risk: analysis of individual patient data from 12 prospective studies. Ann Intern Med 149:461–471

    Article  PubMed  Google Scholar 

  51. Saglam K, Aydur E, Yilmaz M, Goktas S (2003) Leptin influences cellular differentiation and progression in prostate cancer. J Urol 169:1308–1311

    Article  PubMed  CAS  Google Scholar 

  52. Amling CL (2005) Relationship between obesity and prostate cancer. Curr Opin Urol 15:167–171

    Article  PubMed  Google Scholar 

  53. Greenberg AS, Obin MS (2006) Obesity and the role of adipose tissue in inflammation and metabolism. Am J Clin Nutr 83:461–465

    Google Scholar 

  54. Nelson WB, De Marzo AM, DeWeese TL, Isaacs WB (2004) The role of inflammation in the pathogenesis of prostate cancer. J Urol 172:6–11

    Article  Google Scholar 

  55. De Marzo AM, Platz EA, Sutcliffe S et al (2007) Inflammation in prostate carcinogenesis. Nat Rev Cancer 7:256–269

    Article  Google Scholar 

  56. Rebbeck TR, Rennert H, Walker AH et al (2008) Joint effects of inflammation and androgen metabolism on prostate cancer severity. Int J Cancer 123:1385–1389

    Article  PubMed  CAS  Google Scholar 

  57. Spyridopoulos TN, Petridou ET, Dessypris N et al (2009) Inverse association of leptin levels with renal cell carcinoma: results from a case-control study. Hormones (Athens) 8(1):39–46

    Google Scholar 

  58. Lee CT, Dunn RL, Chen BT et al (2004) Impact of body mass index on radical cystectomy. J Urol 172(4 Pt 1):1281–1285

    Article  PubMed  Google Scholar 

  59. Bagrodia A, Grover S, Srivastava A et al (2009) Impact of body mass index on clinical and cost outcomes after radical cystectomy. BJU Int 104(3):326–330

    Article  PubMed  Google Scholar 

Download references

Einhaltung ethischer Richtlinien

Interessenkonflikt. H. Eggers, M.A. Kuczyk, A.J. Schrader und S. Steffens geben an, dass kein Interessenkonflikt besteht. Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

Author information

Authors and Affiliations

  1. Klinik für Urologie und urologische Onkologie, Medizinische Hochschule Hannover, Carl-Neubergstraße 1, 30625, Hannover, Deutschland

    H. Eggers, M.A. Kuczyk &  S. Steffens

  2. Klinik für Urologie, Universitätsklinikum Ulm, Ulm, Deutschland

    A.J. Schrader

Authors
  1. H. Eggers
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. M.A. Kuczyk
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. A.J. Schrader
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. S. Steffens
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to S. Steffens.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Eggers, H., Kuczyk, M., Schrader, A. et al. Der Einfluss von Adipositas auf urologische Tumorerkrankungen. Urologe 52, 1270–1275 (2013). https://doi.org/10.1007/s00120-013-3317-z

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00120-013-3317-z

Schlüsselwörter

Keywords

Search

Navigation