Obesity as a Risk Factor for Prostate Cancer Mortality: A Systematic Review and Dose-Response Meta-Analysis of 280,199 Patients
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AuthorRivera Izquierdo, Mario; Pérez de Rojas, Javier; Martínez Ruiz, Virginia Ana; Sánchez Pérez, María José; Saeed Khan, Khalid; Jiménez Moleón, José Juan
Body mass indexProstate cancer specific mortalityAll-cause mortalityOutcomesCausation
Rivera-Izquierdo, M... [et al.]. Obesity as a Risk Factor for Prostate Cancer Mortality: A Systematic Review and Dose-Response Meta-Analysis of 280,199 Patients. Cancers 2021, 13, 4169. [https://doi.org/10.3390/cancers13164169]
SponsorshipMinistry of Science, Innovation, and Universities of the Spanish Government
The aim of this study was to systematically review all evidence evaluating obesity as a prognostic factor for PC mortality. Cohort and case-control studies reporting mortality among PC patients stratified by body mass index (BMI) were included. The risk of mortality among obese patients (BMI >= 30) was compared with the risk for normal weight (BMI < 25) patients, pooling individual hazard ratios (HR) in random-effects meta-analyses. Reasons for heterogeneity were assessed in subgroup analyses. Dose-response associations for BMI per 5 kg/m(2) change were assessed. Among 7278 citations, 59 studies (280,199 patients) met inclusion criteria. Obesity was associated with increased PC-specific mortality (HR: 1.19, 95% CI: 1.10-1.28, I-2: 44.4%) and all-cause mortality (HR: 1.09, 95% CI: 1.00-1.18, I-2: 43.9%). There was a 9% increase (95% CI: 5-12%, I-2: 39.4%) in PC-specific mortality and 3% increase (95% CI: 1-5%, I-2: 24.3%) in all-cause mortality per 5 kg/m(2) increase in BMI. In analyses restricted to the higher quality subgroup (NOS >= 8), obesity was associated with increased PC-specific mortality (HR: 1.24, 95% CI: 1.14-1.35, I-2: 0.0%) and maintained the dose-response relationship (HR: 1.11 per 5 kg/m(2) increase in BMI, 95% CI: 1.07-1.15, I-2: 26.6%). Obesity had a moderate, consistent, temporal, and dose-response association with PC mortality. Weight control programs may have a role in improving PC survival.