Changes in periprostatic adipose tissue induced by 5α-reductase inhibitors

Area of Science:

• Urology
• Oncology
• Radiology

Background:

• Periprostatic adipose tissue (PPAT) is increasingly recognized for its role in prostate cancer aggressiveness.
• Adipose stromal/stem cells (ASCs) in PPAT may promote tumor growth and metastasis.
• 5α-reductase inhibitors (5ARIs) are used in prostate cancer management, but their effect on PPAT is not well understood.

Purpose of the Study:

• To investigate the interaction between 5ARIs and PPAT in relation to prostate cancer aggressiveness.
• To determine if 5ARI use affects PPAT volume.
• To correlate PPAT measurements with clinical risk assessment scores.

Main Methods:

• Retrospective study of 61 patients treated with 5ARIs for ≥12 months and 117 control patients.
• Abdominal computed tomography (CT) scans were used to measure PPAT, visceral adipose tissue (VAT), and subcutaneous tissue (SAT).
• Pearson correlation and Student's t-test were used for statistical analysis, correlating fat measurements with Cancer of the Prostate Risk Assessment (CAPRA) scores.

Main Results:

• Patients on 5ARIs for ≥12 months had significantly smaller PPAT volume (0.4 cc) compared to controls (0.6 cc) (p < 0.001).
• No significant correlation was found between CAPRA score and fat measurements after adjusting for 5ARI use (p = 0.18).
• In non-5ARI users, BMI correlated with SAT and VAT volume/density, but not PPAT.

Conclusions:

• 5ARIs taken for at least 12 months induce significant changes in PPAT volume.
• The clinical significance of 5ARI-induced changes in PPAT on prostate cancer outcomes remains to be determined.
• Further prospective studies are warranted to elucidate the impact of PPAT modulation by 5ARIs on cancer progression.