SAN FRANCISCO — Men who are overweight or obese have poorer outcomes following robotic radical prostatectomy, according to a poster presentation by Dr. Jay D. Raman and colleagues at the annual meeting of the Society of Laparoendoscopic Surgeons.
Overweight and obese men had a longer operative time, greater blood loss, and longer hospitalizations, compared with men who had normal body mass index (BMI) values.
The study involved 132 patients with clinically localized prostate cancer. Dr. Raman of New York-Presbyterian Hospital, New York, and his colleagues divided the patients into three cohorts, based on BMI, in which 38 patients had a normal BMI (18–24.9 kg/m
The groups had no significant preoperative differences in age, prostate-specific antigen level, or biopsy Gleason score. Obese patients had a significantly higher percentage of clinical T1c cancers (84%), compared with overweight (67%) and normal-weight (55%) patients. Obese patients also had a significantly lower percentage of T2 cancers (16%), compared with overweight (31%) and normal-weight (45%) patients.
The surgery took an average of 304 minutes in obese men, significantly longer than the 235 minutes among overweight men and 238 minutes among normal-weight men.
Normal-weight men lost an estimated 234 mL of blood on average, significantly less than the 318 mL among overweight men and 316 mL among obese men.
Men of normal weight also had significantly shorter hospitalizations: 1.1 days on average, compared with 1.6 days for overweight men and 1.7 days for obese men.
There were no significant differences among the groups in bilateral nerve-sparing (90% overall), open conversion (2% overall), and positive margins (17% overall). Nor did the investigators find significant differences in the complication rate, which was 8% among normal-weight men, 5% among overweight men, and 6% among obese men.
Robotic radical prostatectomies are “technically more challenging” in men with elevated BMI, the authors said.