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Hormone Molecular Biology and Clinical Investigation

Editor-in-Chief: Chetrite, Gérard S.

Editorial Board: Alexis, Michael N. / Baniahmad, Aria / Beato, Miguel / Bouillon, Roger / Brodie, Angela / Carruba, Giuseppe / Chen, Shiuan / Cidlowski, John A. / Clarke, Robert / Coelingh Bennink, Herjan J.T. / Darbre, Philippa D. / Drouin, Jacques / Dufau, Maria L. / Edwards, Dean P. / Falany, Charles N. / Fernandez-Perez, Leandro / Ferroud, Clotilde / Feve, Bruno / Flores-Morales, Amilcar / Foster, Michelle T. / Garcia-Segura, Luis M. / Gastaldelli, Amalia / Gee, Julia M.W. / Genazzani, Andrea R. / Greene, Geoffrey L. / Groner, Bernd / Hampl, Richard / Hilakivi-Clarke, Leena / Hubalek, Michael / Iwase, Hirotaka / Jordan, V. Craig / Klocker, Helmut / Kloet, Ronald / Labrie, Fernand / Mendelson, Carole R. / Mück, Alfred O. / Nicola, Alejandro F. / O'Malley, Bert W. / Raynaud, Jean-Pierre / Ruan, Xiangyan / Russo, Jose / Saad, Farid / Sanchez, Edwin R. / Schally, Andrew V. / Schillaci, Roxana / Schindler, Adolf E. / Söderqvist, Gunnar / Speirs, Valerie / Stanczyk, Frank Z. / Starka, Luboslav / Sutter, Thomas R. / Tresguerres, Jesús A. / Wahli, Walter / Wildt, Ludwig / Yang, Kaiping / Yu, Qi

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Volume 36, Issue 3


Impact of adipose tissue on prostate cancer aggressiveness – analysis of a high-risk population

Guila Delouya
  • Department of Radiation Oncology, Centre hospitalier de l’Université de Montréal, Montréal, QC, Canada
  • CRCHUM-Centre de recherche du Centre Hospitalier de l’Université de Montréal, Montréal, QC, Canada
  • Other articles by this author:
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/ David Tiberi
  • Department of Radiation Oncology, Centre hospitalier de l’Université de Montréal, Montréal, QC, Canada
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/ Sahir R. Bhatnagar
  • Department of Epidemiology, Biostatistics and Occupational Health, McGill University, 1020 Pine Avenue West, Montreal, QC H3A 1A2, Canada
  • Lady Davis Institute for Medical Research, Jewish General Hospital, 3755 Côte Ste. Catherine, Montreal, QC H3T 1E2, Canada
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/ Shanie Campeau
  • Department of Radiation Oncology, Centre hospitalier de l’Université de Montréal, Montréal, QC, Canada
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/ Fred Saad / Daniel Taussky
  • Corresponding author
  • Department of Radiation Oncology, Centre hospitalier de l’Université de Montréal, Montréal, QC, Canada
  • CRCHUM-Centre de recherche du Centre Hospitalier de l’Université de Montréal, Montréal, QC, Canada
  • Email
  • Other articles by this author:
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Published Online: 2018-11-24 | DOI: https://doi.org/10.1515/hmbci-2018-0049



We investigated whether visceral adiposity is associated with more aggressive disease at prostatectomy.

Materials and methods

Four hundred and seventy-four patients referred for postoperative adjuvant or salvage radiotherapy were included in this study. Primary endpoints were positive surgical margins (pSM) or extracapsular extension (ECE). Visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) were manually contoured. Univariate and multivariate logistic regression was performed.


In univariate analysis, VAT volume (p = 0.006), adipose tissue ratio (VAT/SAT, p = 0.003), density of the SAT (p = 0.04), as well as age (p < 0.001) were associated with pSM. In the univariate analysis, SAT density was associated with a trend towards a higher rate of ECE (p = 0.051) but visceral fat volume (p = 0.01), as well as the adipose tissue ratio (p = 0.03) were both protective factors. None of the adipose tissue measurements or BMI had an influence on biochemical recurrence or overall survival (all p ≥ 0.5).


SAT-volume and increased SAT-density were generally associated with more aggressive prostate cancers whereas VAT as a protective factor. These findings emphasize a possible mechanism for the association between obesity and prostate cancer aggressiveness.

Keywords: extracapsular extension; fat density; obesity; positive surgical margins; prostate cancer; visceral fat


  • [1]

    Lauby-Secretan B, Scoccianti C, Loomis D, Grosse Y, Bianchini F, Straif K, et al. Body fatness and cancer – viewpoint of the IARC working group. N Engl J Med. 2016;375:794–8.CrossrefWeb of ScienceGoogle Scholar

  • [2]

    Litwin SE. Good fat, bad fat: the increasingly complex interplay of adipose tissue and the cardiovascular system. J Am Coll Cardiol. 2013;62:136–7.CrossrefPubMedWeb of ScienceGoogle Scholar

  • [3]

    Malietzis G, Aziz O, Bagnall NM, Johns N, Fearon KC, Jenkins JT. The role of body composition evaluation by computerized tomography in determining colorectal cancer treatment outcomes: a systematic review. Eur J Surg Oncol. 2015;41:186–96.CrossrefPubMedGoogle Scholar

  • [4]

    Rickles AS, Iannuzzi JC, Mironov O, Deeb AP, Sharma A, Fleming FJ, et al. Visceral obesity and colorectal cancer: are we missing the boat with BMI? J Gastrointest Surg. 2013;17:133–43; discussion p 143.Web of ScienceCrossrefPubMedGoogle Scholar

  • [5]

    Cakir H, Heus C, van der Ploeg TJ, Houdijk AP. Visceral obesity determined by CT scan and outcomes after colorectal surgery; a systematic review and meta-analysis. Int J Colorectal Dis. 2015;30:875–82.CrossrefWeb of SciencePubMedGoogle Scholar

  • [6]

    Vidal A, Howard L, Sun S, Cooperberg M, Kane C, Aronson WJ, et al. Obesity and prostate cancer-specific mortality after radical prostatectomy: results from the Shared Equal Access Regional Cancer Hospital (SEARCH) database. Prostate Cancer Prostatic Dis. 2016;20:72–8.Web of SciencePubMedGoogle Scholar

  • [7]

    Freedland SJ, Aronson WJ, Kane CJ, Presti JC, Amling CL, Elashoff D, et al. Impact of obesity on biochemical control after radical prostatectomy for clinically localized prostate cancer: a report by the Shared Equal Access Regional Cancer Hospital database study group. J Clin Oncol. 2004;22:446–53.CrossrefGoogle Scholar

  • [8]

    Freedland SJ, Kane CJ, Amling CL, Aronson WJ, Terris MK, Presti JC Jr, et al. Upgrading and downgrading of prostate needle biopsy specimens: risk factors and clinical implications. Urology. 2007;69:495–9.CrossrefPubMedWeb of ScienceGoogle Scholar

  • [9]

    Zilli T, Chagnon M, Van Nguyen T, Bahary JP, Guay JP, Dufresne A, et al. Influence of abdominal adiposity, waist circumference, and body mass index on clinical and pathologic findings in patients treated with radiotherapy for localized prostate cancer. Cancer. 2010;116:5650–8.CrossrefWeb of SciencePubMedGoogle Scholar

  • [10]

    Zilli T, Nguyen T, Bahary J, Chagnon M, Dufresne A, Taussky D. Prognostic impact of abdominal adiposity, waist circumference and body mass index in patients with intermediate-risk prostate cancer treated with radiotherapy. Int J Obes. 2011;35:1421–6.Web of ScienceCrossrefGoogle Scholar

  • [11]

    Nattenmueller J, Hoegenauer H, Boehm J, Scherer D, Paskow M, Gigic B, et al. CT-based compartmental quantification of adipose tissue versus body metrics in colorectal cancer patients. Eur Radiol. 2016;26:4131–40.PubMedCrossrefWeb of ScienceGoogle Scholar

  • [12]

    Mano R, Hakimi AA, Zabor EC, Bury MA, Donati OF, Karlo CA, et al. Association between visceral and subcutaneous adiposity and clinicopathological outcomes in non-metastatic clear cell renal cell carcinoma. Can Urol Assoc J. 2014;8:E675–80.CrossrefWeb of SciencePubMedGoogle Scholar

  • [13]

    Balentine CJ, Marshall C, Robinson C, Wilks J, Anaya D, Albo D, et al. Validating quantitative obesity measurements in colorectal cancer patients. J Surg Res. 2010;164:18–22.Web of ScienceCrossrefPubMedGoogle Scholar

  • [14]

    Murphy RA, Register TC, Shively CA, Carr JJ, Ge Y, Heilbrun ME, et al. Adipose tissue density, a novel biomarker predicting mortality risk in older adults. J Gerontol A Biol Sci Med Sci. 2014;69:109–17.CrossrefPubMedGoogle Scholar

  • [15]

    Alvey NJ, Pedley A, Rosenquist KJ, Massaro JM, O’Donnell CJ, Hoffmann U, et al. Association of fat density with subclinical atherosclerosis. J Am Heart Assoc. 2014:3.Web of SciencePubMedGoogle Scholar

  • [16]

    Veld J, Vossen JA, De Amorim Bernstein K, Halpern EF, Torriani M, Bredella MA. Adipose tissue and muscle attenuation as novel biomarkers predicting mortality in patients with extremity sarcomas. Eur Radiol. 2016;26:4649–55.Web of ScienceCrossrefPubMedGoogle Scholar

  • [17]

    Rosenquist KJ, Pedley A, Massaro JM, Therkelsen KE, Murabito JM, Hoffmann U, et al. Visceral and subcutaneous fat quality and cardiometabolic risk. JACC Cardiovasc Imaging. 2013;6:762–71.PubMedWeb of ScienceCrossrefGoogle Scholar

  • [18]

    Zimmermann M, Delouya G, Barkati M, Campeau S, Rompotinos D, Taussky D. Impact of visceral fat volume and fat density on biochemical outcome after radical prostatectomy and postoperative radiotherapy. Horm Mol Biol Clin Investig. 2016;26:173–8.Web of SciencePubMedGoogle Scholar

  • [19]

    Albiges L, Hakimi AA, Xie W, McKay RR, Simantov R, Lin X, et al. Body mass index and metastatic renal cell carcinoma: clinical and biological correlations. J Clin Oncol. 2016;34:3655–63.CrossrefWeb of SciencePubMedGoogle Scholar

  • [20]

    Ladoire S, Bonnetain F, Gauthier M, Zanetta S, Petit JM, Guiu S, et al. Visceral fat area as a new independent predictive factor of survival in patients with metastatic renal cell carcinoma treated with antiangiogenic agents. Oncologist. 2011;16:71–81.CrossrefPubMedWeb of ScienceGoogle Scholar

  • [21]

    Iyengar NM, Gucalp A, Dannenberg AJ, Hudis CA. Obesity and cancer mechanisms: Tumor microenvironment and inflammation. J Clin Oncol. 2016;34:4270–6.CrossrefPubMedWeb of ScienceGoogle Scholar

  • [22]

    Pouliot MC, Despres JP, Lemieux S, Moorjani S, Bouchard C, Tremblay A, et al. Waist circumference and abdominal sagittal diameter: best simple anthropometric indexes of abdominal visceral adipose tissue accumulation and related cardiovascular risk in men and women. Am J Cardiol. 1994;73:460–8.PubMedCrossrefGoogle Scholar

  • [23]

    Festa A, D’Agostino R Jr, Williams K, Karter AJ, Mayer-Davis EJ, Tracy RP, et al. The relation of body fat mass and distribution to markers of chronic inflammation. Int J Obes Relat Metab Disord. 2001;25:1407–15.PubMedCrossrefGoogle Scholar

  • [24]

    Von Hafe P, Pina F, Pérez A, Tavares M, Barros H. Visceral fat accumulation as a risk factor for prostate cancer. Obes Res. 2004;12:1930–5.PubMedCrossrefGoogle Scholar

  • [25]

    Finley DS, Calvert VS, Inokuchi J, Lau A, Narula N, Petricoin EF, et al. Periprostatic adipose tissue as a modulator of prostate cancer aggressiveness. J Urol. 2009;182:1621–7.CrossrefPubMedGoogle Scholar

  • [26]

    Taussky D, Barkati M, Campeau S, Zerouali K, Nadiri A, Saad F, et al. Changes in periprostatic adipose tissue induced by 5α‐reductase inhibitors. Andrology. 2017;5:511–5.PubMedWeb of ScienceCrossrefGoogle Scholar

  • [27]

    Iyengar NM, Zhou XK, Gucalp A, Morris PG, Howe LR, Giri DD, et al. Systemic correlates of white adipose tissue inflammation in early-stage breast cancer. Clin Cancer Res. 2016;22:2283–9.CrossrefWeb of SciencePubMedGoogle Scholar

  • [28]

    Iyengar NM, Ghossein RA, Morris LG, Zhou XK, Kochhar A, Morris PG, et al. White adipose tissue inflammation and cancer‐specific survival in patients with squamous cell carcinoma of the oral tongue. Cancer. 2016;122:3794–802.PubMedCrossrefWeb of ScienceGoogle Scholar

  • [29]

    Ellem SJ, Risbridger GP. Aromatase and regulating the estrogen: androgen ratio in the prostate gland. J Steroid Biochem Mol Biol. 2010;118:246–51.PubMedWeb of ScienceCrossrefGoogle Scholar

About the article

Received: 2018-07-06

Accepted: 2018-09-11

Published Online: 2018-11-24

Author Statement

Research funding: Authors state no funding involved.

Conflict of interest: Authors state no conflict of interest.

Informed consent: For this retrospective study no informed consent was necessary.

Ethical approval: Local ethics board approval was obtained.

Citation Information: Hormone Molecular Biology and Clinical Investigation, Volume 36, Issue 3, 20180049, ISSN (Online) 1868-1891, DOI: https://doi.org/10.1515/hmbci-2018-0049.

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