BACKGROUND Epidemiological studies have shown an association between obesity and prostate cancer (PCa) aggressiveness. However, little is known about periprostatic fat (PPF) and its relationship with overall fat deposition in PCa. PPF is thought to contribute to PCa growth and migration via secreted factors and induction of chronic inflammation. We investigated if pre-treatment PPF thickness correlates with overall survival (OS). METHODS We reviewed 85 hormone-naïve men with advanced PCa who had received androgen deprivation therapy (ADT). PPF thickness was measured by magnetic resonance imaging (MRI) and compared with subcutaneous fat (SCF) thickness as an internal control. Visceral fat (VF) area measured by computed tomography served as an additional control. We evaluated the relationship between laboratory data, pathology results, and obesity parameters and OS. RESULTS Median follow-up was 50.6 months. Thirty-six patients died during follow-up. Univariate analysis revealed that nadir PSA titer, Gleason score, N stage, M stage, extent of disease by bone scan grade, hemoglobin, lactate dehydrogenase, alkaline phosphatase, and PPF/SCF ratio were associated with OS. Multivariate analysis revealed that nadir PSA titer, N stage, and PPF/SCF ratio were independent prognostic factors for survival. The 5-year OS in the patients with higher PPF/SCF ratio (≥ 1) and lower PPF/SCF ratio (< 1) was 49.5% and 66.5%, respectively (P = 0.039). CONCLUSIONS Pre-treatment ratio of PPF-to-SCF thickness on MRI is an independent predictor of survival in hormone-naïve men with advanced PCa. This could be useful for predicting which patients are more likely to develop castration-resistant PCa.

中文翻译：

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MRI上前列腺癌周围与皮下脂肪厚度的治疗前比率是无激素的晚期前列腺癌男性的独立生存预测指标。

背景技术流行病学研究表明，肥胖与前列腺癌（PCa）侵袭性之间存在关联。但是，对前列腺周围脂肪（PPF）及其与PCa中总体脂肪沉积的关系知之甚少。PPF被认为通过分泌因子和诱导慢性炎症来促进PCa的生长和迁移。我们调查了预处理PPF厚度是否与总生存期（OS）相关。方法我们回顾了85位接受过雄激素剥夺疗法（ADT）的激素水平未成熟的晚期PCa男性。通过磁共振成像（MRI）测量PPF厚度，并将其与皮下脂肪（SCF）厚度进行比较，作为内部对照。通过计算机体层摄影术测量的内脏脂肪（VF）面积用作其他对照。我们评估了实验室数据，病理结果，肥胖参数和OS。结果中位随访时间为50.6个月。随访期间有36例患者死亡。单因素分析表明，最低点PSA滴度，格里森评分，N期，M期，骨扫描分级，血红蛋白，乳酸脱氢酶，碱性磷酸酶和PPF / SCF比值与疾病程度有关。多变量分析显示最低的PSA滴度，N期和PPF / SCF比是生存的独立预后因素。PPF / SCF比率较高（≥1）和PPF / SCF比率较低（<1）的患者的5年OS分别为49.5％和66.5％（P = 0.039）。结论MRI上PPF对SCF厚度的预处理比率是激素未成熟男性晚期PCa生存率的独立预测指标。这对于预测哪些患者更有可能发展去势抵抗性PCa可能有用。