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Prostate Cancer
Volume 2014, Article ID 478983, 6 pages
http://dx.doi.org/10.1155/2014/478983
Research Article

Evidence Suggesting That Obesity Prevention Measures May Improve Prostate Cancer Outcomes Using Data from a Prospective Randomized Trial

1Harvard Radiation Oncology Program, Harvard Medical School, 75 Francis Street, L2, Boston, MA 02115, USA
2Department of Statistics, University of Connecticut, 215 Glenbrook Road, U-4120, Storrs, CT 06269, USA
3Department of Radiation Oncology, Dana-Farber Cancer Institute and Brigham and Women’s Hospital, 75 Francis Street, L2, Boston, MA 02115, USA

Received 21 October 2013; Accepted 6 January 2014; Published 13 February 2014

Academic Editor: David K. Ornstein

Copyright © 2014 Ravi A. Chandra et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose. Increasing body mass index (BMI) is associated with higher risk prostate cancer (PC) at presentation. Whether increasing BMI also prompts earlier salvage androgen suppression therapy (sAST) is unknown. Materials and Methods. Between 1995 and 2001, 206 men with unfavorable risk PC were treated with radiation therapy (RT) or RT and six months of androgen suppression therapy in a randomized controlled trial (RCT). 108 sustained PSA failure; 51 received sAST for PSA approaching 10 ng/mL; 49 with BMI data comprised the study cohort. A multivariable Cox regression analysis identified pretreatment factors associated with earlier sAST receipt. Results. Increasing BMI prompted earlier sAST (median years: 3.7 for overweight/obese, 6.9 for normal weight; adjusted hazard ratio (AHR): 1.11; 95% CI: 1.04, 1.18; ) as did high versus other risk PC (median: 3.2 versus 5.2 years; AHR: 2.01; 95% CI: 1.05, 3.83; ). Increasing median time to sAST was observed for overweight/obese men with high versus other risk PC and for normal-weight men with any risk PC being 2.3, 4.6, and 6.9 years, respectively ( for trend). Conclusion. Increasing BMI was associated with earlier sAST. A RCT evaluating whether BMI reduction delays or eliminates need for sAST is warranted.