Prostate cancer postoperative nomogram scores and obesity.

Area of Science:

• Urology
• Oncology
• Clinical Prediction Modeling

Background:

• Prostate cancer nomograms are vital for predicting outcomes and guiding treatment decisions.
• The utility of prostate cancer nomograms has significantly increased.
• Limited data exists on the relationship between nomogram predictions and patient obesity.

Purpose of the Study:

• To investigate the association between obesity and the predicted probabilities from a validated postoperative prostate cancer nomogram.
• To determine if obesity influences the accuracy or applicability of existing prostate cancer prognostic tools.

Main Methods:

• A cross-sectional analysis was conducted on 1220 patients who underwent radical prostatectomy (RP).
• Progression-free probabilities (PFPs) were calculated using the 10-year Kattan postoperative nomogram.
• Multivariable logistic regression models were employed to assess associations, calculating odds ratios (ORs) and 95% confidence intervals (CIs).

Main Results:

• Obesity was associated with aggressive prostate cancer (Gleason ≥7; p=0.01), but not advanced stage.
• After adjusting for covariates, obesity showed an inverse association with 10-year progression-free predictions (OR=0.50; 95% CI=0.28-0.90).
• Obesity was positively associated with preoperative PSA levels (OR=1.23; 95% CI=1.01-1.50) and Gleason score >7 (OR=1.45; 95% CI=1.11-1.90).

Conclusions:

• Obese patients undergoing RP had lower predicted progression-free probabilities compared to non-obese patients.
• This suggests that obesity may indicate a higher risk of prostate cancer progression.
• Identifying obese individuals may enhance prognostic accuracy and inform treatment strategies for prostate cancer.