ONCOmmunity

Periprostatic Fat: A Risk Factor for Prostate Cancer?

By: Wei Phin Tan, Carol Lin, Meri Chen, Leslie Deane

Department of Urology Rush University Medical Center, Chicago. Electronic address: tanweiphin@yahoo.com.
2016-6-6; doi: 10.1016/j.urology.2016.07.042

Abstract

Introduction

Obesity has been correlated with high grades of prostate cancer. Body mass index and waist circumference are not good surrogates for obesity.

Objective

To evaluate whether periprostatic fat volume and periprostatic fat ratio as determined by multi-parametric magnetic resonance imaging correlates with the presence of high-grade prostate cancer.

Materials

A total of 295 consecutive patients (Median age 64, range 38-84) underwent mpMRI of the prostate gland between August 2013 and February 2015. All patients underwent a 3 Tesla multi-parametric MRI. Using DynaCAD (Invivo, Gainesville Florida, USA), we calculated the prostate volume and volume of the periprostatic fat seen on mpMRI. The peri-prostatic fat ratio was calculated using the formula peri-prostatic fat volume / prostate volume).

Results

A higher periprostatic fat volume (p<0.001) and a higher periprostatic fat ratio (p<0.001) were significantly associated with a higher Gleason Score. Periprostatic fat ratio is a better predictor of higher Gleason Score compare to periprostatic fat volume (p<0.001). There was no correlation observed between periprostatic fat ratio and PSA (Median 7.34, range 0.36-59.7, p=0.274), age (Median 64, range 38-84, p=0.665) or BMI (Median 28.33, range 17.99-45.44, p=0.310). Patients with a higher periprostatic fat ratio were more likely to undergo intervention for prostate cancer.

Conclusion

A higher periprostatic fat ratio is significantly associated with a higher Gleason Score. Periprostatic fat ratio is a better predictor of higher Gleason Score compare to periprostatic fat volume and may be an important risk factor in diagnosing patients higher grade prostate cancer.