Role of abdominal obesity for functional outcomes and complications in men treated with radical prostatectomy for prostate cancer: results of the Multicenter Italian Report on Radical Prostatectomy (MIRROR) study. (April 2014)

• Record Type: Journal Article
• Authors: Gacci, Mauro; Sebastianelli, Arcangelo; Salvi, Matteo; De nunzio, Cosimo; Schiavina, Riccardo; Simonato, Alchiede; Tubaro, Andrea; Mirone, Vincenzo; Carini, Marco; Carmignani, Giorgio
• Is Part Of: Scandinavian journal of urology. Volume 48:Number 2(2014)
• Page Start: 138
• Page End: 145
• Publication Date: 2014-04
• Subjects: Urology -- Periodicals; 616.6
• DOI: 10.3109/21681805.2013.803151
• Languages: English
• ISSNs: 2168-1805

Abstract

<abstract> <title>Abstract</title> <p> <italic>Objective.</italic> This study aimed to evaluate the impact of abdominal obesity on preoperative features, complications and functional outcomes of men treated with radical prostatectomy (RP) for prostate cancer. <italic>Material and methods.</italic> In 2006 a multicentre Italian report on RP evaluated the surgical and functional characteristics of prostate cancer and RP outcomes. Age and waist circumference (WC) were recorded. Abdominal obesity was defined as a WC of at least 102 cm. International Index of Erectile Function (IIEF) score, prostate-specific antigen, prostate volume, tumour characteristics, presence/absence of perioperative complications and the number of blood units transfused were recorded. Preoperative and postoperative continence status was evaluated. Spearman correlation coefficient and binary logistic regression analyses were conducted. <italic>Results.</italic> In total, 470 men were recruited. A significant negative correlation between WC and preoperative IIEF scores was observed (<italic>r</italic> = –0.032, <italic>p</italic> < 0.001). Non-obese patients presented a preoperative IIEF score of 18.8 ± 6.0 and obese patients an IIEF score of 16.0 ± 7.0 (<italic>p</italic> < 0.001). Obese men are at three-fold greater risk of intraoperative complications and blood transfusions than those with a WC below 102 cm [adjusted odds ratio (OR) = 3.116, 95% confidence interval (CI) 0.281–16.348, <italic>p</italic> < 0.001, and OR = 2.763, 95% CI 0.518–3.843, <italic>p</italic> < 0.050, respectively]. A significant positive correlation between WC and postprostatectomy incontinence severity was observed. The risk of needing at least two pads per day is two and a half times greater in men with a WC of at least 102 cm than in those with a WC below 102 cm (adjusted OR = 2.435, 95% CI 0.321–7.668, <italic>p</italic> = 0.007). <italic>Conclusion.</italic> Abdominal obesity in a multicentre Italian cohort of patients treated with RP was associated with an increased risk of intraoperative and perioperative complications and with a worse functional outcome.</p> </abstract>