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Obesity and mortality in men with locally advanced prostate cancer : analysis of RTOG 85-31 . BACKGROUND Greater body mass index ( BMI ) is associated with shorter time to prostate-specific antigen ( PSA ) failure following radical prostatectomy and radiation therapy ( RT ) . Whether BMI is associated with prostate cancer-specific mortality ( PCSM ) was investigated in a large randomized trial of men treated with RT and androgen deprivation therapy ( ADT ) for locally advanced prostate cancer . METHODS Between 1987 and 1992 , 945 eligible men with locally advanced prostate cancer were enrolled in a phase 3 trial ( RTOG 85-31 ) and randomized to RT and immediate goserelin or RT alone followed by goserelin at recurrence . Height and weight data were available at baseline for 788 ( 83 % ) subjects . Cox regression analyses were performed to evaluate the relations between BMI and all-cause mortality , PCSM , and nonprostate cancer mortality . Covariates included age , race , treatment arm , history of prostatectomy , nodal involvement , Gleason score , clinical stage , and BMI . RESULTS The 5-year PCSM rate for men with BMI < 25 kg/m ( 2 ) was 6.5 % , compared with 13.1 % and 12.2 % in men with BMI > or =25 to < 30 and BMI > or =30 , respectively ( Gray 's P = .005 ) . In multivariate analyses , greater BMI was significantly associated with higher PCSM ( for BMI > or =25 to < 30 , hazard ratio [ HR ] 1.52 , 95 % confidence interval [ CI ] , 1.02-2.27 , P = .04 ; for BMI > or =30 , HR 1.64 , 95 % CI , 1.01-2.66 , P = .04 ) . BMI was not associated with nonprostate cancer or all-cause mortality . CONCLUSIONS Greater baseline BMI is independently associated with higher PCSM in men with locally advanced prostate cancer . Further studies are warranted to evaluate the mechanism ( s ) for increased cancer-specific mortality and to assess whether weight loss after prostate cancer diagnosis alters disease course .
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Intervention_Surgical
radical prostatectomy
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Intervention_Pharmacological
radiation therapy
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Intervention_Pharmacological
RT and androgen deprivation therapy ( ADT )
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Intervention_Pharmacological
RT and immediate goserelin
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Intervention_Pharmacological
RT alone followed by goserelin
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Outcome_Physical
body mass index ( BMI )
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Outcome_Physical
BMI
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Outcome_Mortality
all-cause mortality
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Outcome_Mortality
PCSM
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Outcome_Mortality
nonprostate cancer mortality
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Outcome_Mortality
5-year PCSM rate
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Outcome_Physical
BMI
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Outcome_Mortality
higher PCSM
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Outcome_Physical
BMI
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Outcome_Mortality
nonprostate cancer
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Outcome_Mortality
all-cause mortality
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Outcome_Physical
baseline BMI
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Outcome_Mortality
PCSM
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Outcome_Mortality
cancer-specific mortality
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Outcome_Physical
weight loss
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Participant_Condition
locally advanced prostate cancer :
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Participant_Age
men
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Participant_Condition
androgen deprivation therapy ( ADT ) for