Associations of fat and muscle mass with overall survival in men with prostate cancer: A systematic review with meta-analysis
Pedro Lopez, Edith Cowan UniversityFollow
Robert U. Newton, Edith Cowan UniversityFollow
Dennis R. Taaffe, Edith Cowan UniversityFollow
Favil Singh, Edith Cowan UniversityFollow
Laurien M. Buffart, Edith Cowan UniversityFollow
Nigel Spry, Edith Cowan UniversityFollow
Colin Tang, Edith Cowan UniversityFollow
Daniel A. Galvao, Edith Cowan UniversityFollow
Robert U Newton
Daniel A Galvao
Prostate Cancer and Prostatic Diseases
School of Medical and Health Sciences / Exercise Medicine Research Institute / Centre for Exercise and Sports Science Research
Edith Cowan University - Open Access Support Scheme 2021
National Health and Medical Research Council, Centre of Research Excellence in Prostate Cancer Survivorship Scholarship
To systematically review and analyse the associations between fat and muscle mass measures with overall survival in men with prostate cancer.
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.
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.
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.
Lopez Da Cruz, P. (2023). Exploring demographic, clinical and exercise prescription moderators of resistance exercise effects on objectively measured and patient-reported outcomes in men with prostate cancer. https://ro.ecu.edu.au/theses/2632
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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