• Yu-Hsuan Chien, Ming-Li Hsieh, Ting-Wen Sheng, Ying-Hsu Chang, Li-Jen Wang, Cheng-Keng Chuang, See-Tong Pang, Chun-Te Wu, and I-Hung Shao.
• Division of Urology, Department of Surgery, Linkou Chang Gung Memorial Hospital.
• Medicine (Baltimore). 2022 Oct 7; 101 (40): e31076e31076.

AbstractThis study evaluated the effect of body composition and pelvic fat distribution on the aggressiveness and prognosis of localized prostate cancer. This study included patients who underwent robot-assisted radical prostatectomy with positive surgical margins. Clinicodemographic data were collected from patients' medical reports. Pretreatment magnetic resonance images (MRI) obtained for cancer staging were reviewed by a single radiologist to calculate pelvic fat distribution and body composition. We correlated these body composition parameters with initial prostate-specific antigen (iPSA), Gleason score, extracapsular tumor extension, and biochemical recurrence (BCR)-free survival. The iPSA was significantly associated with body mass index (BMI; P = .027), pelvic fat volume (P = .004), and perirectal fat volume (P = .001), whereas the Gleason score was significantly associated with BMI only (P = .011). Tumor extracapsular extension was significantly associated with increased periprostatic fat volume (P = .047). Patients with less subcutaneous fat thickness (<2.4 cm) had significantly poor BCR-free survival (P = .039). Pelvic fat distribution, including pelvic fat volume, perirectal fat volume, and periprostatic fat volume, were significantly correlated with prostate cancer aggressiveness. Patients with less subcutaneous fat had an increased risk of BCR after radical prostatectomy.Copyright © 2022 the Author(s). Published by Wolters Kluwer Health, Inc.

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