Radical prostatectomy in obese men with prostate cancer (prostate cancer)
Being overweight can be unhealthy. But his influence on the operation in localized prostate cancer, is hardly limited to a few significant points falling, so new studies by the German Association of Urology congress in 2006.
Among overweight is generally understood to an increase in body fat mass. It can be approximated most easily using the Body Mass Index (BMI, body mass index) indicate the calculated as the ratio of body weight (in kg) and the square of height (in m). As a moderate overrepresentation applies a BMI of 25kg/qm, as distinct from a BMI 30kg/qm and as extreme a BMI of 40kg/qm.
Obesity is known to be associated with increased total mortality (eg due to increased heart attack risk). In addition, it is also one of the risk factors for prostate cancer be (see causes of prostate cancer ). Has now been tested in four new studies, the influence of obesity on the outcome of radical prostatectomy (RPE) has.
In the first study of 1302 patients were included in which an RPE had been carried out. Here it was found that a BMI of as 28kg/qm total mortality independent of other factors increases, but not the mortality from prostate cancer or a possible second tumor. More The BMI should therefore, according to the authors, are taken into account when deciding on the treatment in addition to the patient's age, its possible comorbidities and the nature and spread of prostate cancer.
The second study included 1545 patients after RPE. A high BMI extended only after the hospital stay by one day and increased the risk of wound infection after surgery (Note: fat is not well supplied with blood, and wounds heal slowly). Otherwise, the BMI had no effect on the operation itself, complications during and after the operation, the recovering of continence (ability to hold water), and the elimination of tumor (for example, PSA-free survival).
In the two remaining studies, the RPE was performed endoscopically (via endoscope = "reflection", such procedures are considered minimally intrusive). Again, there was only a small influence of BMI on the evaluated parameters: the feasibility of the operation remained unaffected, only the operation time increased. In addition, in one study were not obese patients on average earlier continent again than overweight. In the other study was also pointed out that in overweight of hospital stay was not extended, however, the endoscopic had to be frequently converted to open surgery (higher conversion rate because of intraoperative difficulties).
Post a Comment