Anthropometric assessment of obesity in robotic-assisted laparoscopic prostatectomy: A systematic review

Obesity rates are rising among prostate cancer patients undergoing robotic-assisted laparoscopic prostatectomy (RALP). This review evaluates the anthropometric tools used to study this group and their correlation with surgical outcomes. Our objective is to identify which obesity metrics have been measured against clinically relevant surgical outcomes in patients undergoing RALP to enable more accurate risk stratification and improved patient counselling.

Five databases (Ovid, Medline, Web of Science, Cochrane, Scopus) were systematically searched in March 2025 for studies examining obesity metrics and RALP outcomes. Inclusion criteria: English-language studies from the last 15 years with ≥15 patients undergoing transperitoneal RALP. Two independent reviewers screened articles and assessed bias using the Newcastle-Ottawa Scale. Data on anthropometric tools, patient demographics, obesity definitions and outcomes were extracted and analysed descriptively.

Search strategy yielded 15 papers in total demonstrating that body mass index (BMI) is the only anthropometric tool used in surgical research to assess obese patients for relevant outcomes from RALP. Outcomes observed were categorised as functional, oncological and perioperative. Most studies examined a combination of all three.

The data consistently utilises BMI to measure obesity in RALP patients, with numerous surgical outcomes explored in the literature. However, there is a paucity of studies examining alternative obesity metrics. Given the abdomino-pelvic site of prostatectomy, metrics that more accurately assess body fat distribution in this anatomical area may be more appropriate for research and clinical practice.