Document Type

Journal Article

Publication Title

Prostate Cancer and Prostatic Diseases

Publisher

Springer Nature

School

School of Medical and Health Sciences / Exercise Medicine Research Institute / Centre for Exercise and Sports Science Research

RAS ID

36880

Funders

Edith Cowan University - Open Access Support Scheme 2021

National Health and Medical Research Council, Centre of Research Excellence in Prostate Cancer Survivorship Scholarship

Comments

Lopez, P., Newton, R. U., Taaffe, D. R., Singh, F., Buffart, L. M., Spry, N., . . . Galvão, D. A. (2022). Associations of fat and muscle mass with overall survival in men with prostate cancer: A systematic review with meta-analysis. Prostate Cancer and Prostatic Diseases. https://doi.org/10.1038/s41391-021-00442-0

Abstract

Background

To systematically review and analyse the associations between fat and muscle mass measures with overall survival in men with prostate cancer.

Methods

A systematic search was conducted in CINAHL, Cochrane Library, EMBASE, PubMed, and Web of Science databases from inception to December 2020, while abstracts from the American Society of Clinical Oncology (ASCO), Clinical Oncology Society of Australia (COSA), and the American College of Sports Medicine (ACSM) conferences were searched from 2014 to 2020. Eligible articles examined the association of body composition measures, such as fat mass (e.g., fat mass, visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT), and VAT/SAT) and muscle mass measures, with overall survival in prostate cancer patients at any treatment stage. The primary endpoint was overall survival. Random-effect meta-analysis was conducted for studies reporting multivariable or univariable analysis assessing the associations of fat mass measures (i.e., fat mass, VAT, SAT, VAT/SAT) and muscle mass measures with overall survival.

Results

Sixteen cohort studies that comprised 4807 men with prostate cancer were included. Total adiposity (hazard ratio (HR) 0.98, 95% CI: 0.75–1.28, p = 0.888) and VAT (HR 1.03, 95% CI: 0.74–1.43, p = 0.873) were not significantly associated with overall survival, while higher subcutaneous adipose tissue levels were associated with higher survival (HR 0.68, 95% CI: 0.54–0.84, p = 0.001). Greater mortality risk was found in patients with localised (HR 1.91, 95% CI: 1.40–2.62, p < 0.001) and advanced disease (HR 1.43, 95% CI: 1.07–1.92, p = 0.020) presenting with low levels of muscle mass compared to those presenting with high levels.

Discussion

These results indicate that although overall adiposity should be cautiously interpreted in regards to survival, high muscle mass and SAT, and low VAT/SAT ratio values are associated with overall survival in men with prostate cancer.

DOI

10.1038/s41391-021-00442-0

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Link to publisher version (DOI)

10.1038/s41391-021-00442-0