DaPeCa5 - obesity at the time of diagnosis does not predict poor cancer-specific survival in patients with penile squamous cell carcinoma - a Danish National study

Jakob Kristian Jakobsen; Dennis Kortsen; Jørgen Bjerggaard Jensen

doi:10.1080/21681805.2020.1803399

DaPeCa5 - obesity at the time of diagnosis does not predict poor cancer-specific survival in patients with penile squamous cell carcinoma - a Danish National study

Jakob Kristian Jakobsen, Dennis Kortsen, Jørgen Bjerggaard Jensen

Publikation: Bidrag til tidsskrift/Konferencebidrag i tidsskrift /Bidrag til avis › Tidsskriftartikel › Forskning › peer review

Abstract

BACKGROUND: Conflicting data on the prognostic significance of obesity in penile cancer have been presented in recent years.

OBJECTIVE: The objective of this study was to investigate obesity as a prognostic factor in patients with penile squamous cell carcinoma (pSCC) in a large national Danish cohort. Furthermore we aimed to compare the BMI of pSCC patients to a large age-matched cohort of healthy men.

METHODS: We evaluated 429 patients with invasive pSCC from a national retrospective penile cancer cohort and defined a body mass index (BMI) at 30 kg/m2 as obese. Furthermore, we considered if a fitted model for BMI and mortality could define a critical BMI tipping point for increasing mortality by the means of BMI categories of 1 kg/m2 width. We compared 29 pSCC patients with reported unintended weight loss at diagnosis to 400 with no reported weight loss. Cox regression with 95% confidence intervals was used for penile cancer-specific survival analysis. The comparison between 325 age-matched pSCC patients and 11,238 healthy men from an existing contemporary health database was done by nonparametric tests.

RESULTS: There was no difference in cancer specific survival between patients with a BMI below and above 30 kg/m2, cox hazard ratio (HR) 0.74 (0.47-1.18), p = .20, but 37 kg/m2 was a tipping point for increasing mortality, HR = 2.10 (1.06-4.18), p = .035. Unintentional weight loss prior to diagnosis significantly predicted worse cancer specific outcome, cox hazard ratio 6.0 (3.5-10.0), p < 001 and cox hazard ratio adjusted for American Joint Committee of Cancer (AJCC)-stage at 1.8 (1.1-3.1), p = .03. Age-matched pSCC patients had a significantly higher BMI than healthy males, 28.4 ± 5.5 kg/m2 vs. 26.2 ± 3.6 kg/m2, p < .0001 and were more likely to smoke, p < .0001, and report alcohol intakes over 14 units/week, p < .0001.

CONCLUSION: In this Danish cohort, BMI above 30 kg/m2 at diagnosis does not affect prognosis, but BMI at and above 37 kg/m2 at diagnosis predicts poor prognosis. Unintentional weight loss is a predictor of high stage and poor prognosis. PSCC patients have a significantly higher BMI than age-matched healthy males.

Originalsprog	Engelsk
Tidsskrift	Scandinavian Journal of Urology
Vol/bind	54
Nummer	5
Sider (fra-til)	420-425
Antal sider	6
ISSN	2168-1805
DOI	https://doi.org/10.1080/21681805.2020.1803399
Status	Udgivet - sep. 2020

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10.1080/21681805.2020.1803399

Citationsformater

@article{e78f36034aae434b80e14532248116c9,

title = "DaPeCa5 - obesity at the time of diagnosis does not predict poor cancer-specific survival in patients with penile squamous cell carcinoma - a Danish National study",

abstract = "BACKGROUND: Conflicting data on the prognostic significance of obesity in penile cancer have been presented in recent years.OBJECTIVE: The objective of this study was to investigate obesity as a prognostic factor in patients with penile squamous cell carcinoma (pSCC) in a large national Danish cohort. Furthermore we aimed to compare the BMI of pSCC patients to a large age-matched cohort of healthy men.METHODS: We evaluated 429 patients with invasive pSCC from a national retrospective penile cancer cohort and defined a body mass index (BMI) at 30 kg/m2 as obese. Furthermore, we considered if a fitted model for BMI and mortality could define a critical BMI tipping point for increasing mortality by the means of BMI categories of 1 kg/m2 width. We compared 29 pSCC patients with reported unintended weight loss at diagnosis to 400 with no reported weight loss. Cox regression with 95% confidence intervals was used for penile cancer-specific survival analysis. The comparison between 325 age-matched pSCC patients and 11,238 healthy men from an existing contemporary health database was done by nonparametric tests.RESULTS: There was no difference in cancer specific survival between patients with a BMI below and above 30 kg/m2, cox hazard ratio (HR) 0.74 (0.47-1.18), p = .20, but 37 kg/m2 was a tipping point for increasing mortality, HR = 2.10 (1.06-4.18), p = .035. Unintentional weight loss prior to diagnosis significantly predicted worse cancer specific outcome, cox hazard ratio 6.0 (3.5-10.0), p < 001 and cox hazard ratio adjusted for American Joint Committee of Cancer (AJCC)-stage at 1.8 (1.1-3.1), p = .03. Age-matched pSCC patients had a significantly higher BMI than healthy males, 28.4 ± 5.5 kg/m2 vs. 26.2 ± 3.6 kg/m2, p < .0001 and were more likely to smoke, p < .0001, and report alcohol intakes over 14 units/week, p < .0001.CONCLUSION: In this Danish cohort, BMI above 30 kg/m2 at diagnosis does not affect prognosis, but BMI at and above 37 kg/m2 at diagnosis predicts poor prognosis. Unintentional weight loss is a predictor of high stage and poor prognosis. PSCC patients have a significantly higher BMI than age-matched healthy males.",

keywords = "Penile cancer, cause specific survival, mortality, obesity, prognosis, squamous cell carcinoma, weight loss, MORTALITY, CIRCUMCISION, SMOKING, TRENDS, OBESITY, MEN, BODY-MASS INDEX, PHYSICAL-ACTIVITY",

author = "Jakobsen, {Jakob Kristian} and Dennis Kortsen and Jensen, {J{\o}rgen Bjerggaard}",

year = "2020",

month = sep,

doi = "10.1080/21681805.2020.1803399",

language = "English",

volume = "54",

pages = "420--425",

journal = "Scandinavian Journal of Urology",

issn = "2168-1805",

publisher = "Taylor & Francis",

number = "5",

}

DaPeCa5 - obesity at the time of diagnosis does not predict poor cancer-specific survival in patients with penile squamous cell carcinoma - a Danish National study. / Jakobsen, Jakob Kristian ; Kortsen, Dennis ; Jensen, Jørgen Bjerggaard.
I: Scandinavian Journal of Urology, Bind 54, Nr. 5, 09.2020, s. 420-425.

Publikation: Bidrag til tidsskrift/Konferencebidrag i tidsskrift /Bidrag til avis › Tidsskriftartikel › Forskning › peer review

TY - JOUR

T1 - DaPeCa5 - obesity at the time of diagnosis does not predict poor cancer-specific survival in patients with penile squamous cell carcinoma - a Danish National study

AU - Jakobsen, Jakob Kristian

AU - Kortsen, Dennis

AU - Jensen, Jørgen Bjerggaard

PY - 2020/9

Y1 - 2020/9

N2 - BACKGROUND: Conflicting data on the prognostic significance of obesity in penile cancer have been presented in recent years.OBJECTIVE: The objective of this study was to investigate obesity as a prognostic factor in patients with penile squamous cell carcinoma (pSCC) in a large national Danish cohort. Furthermore we aimed to compare the BMI of pSCC patients to a large age-matched cohort of healthy men.METHODS: We evaluated 429 patients with invasive pSCC from a national retrospective penile cancer cohort and defined a body mass index (BMI) at 30 kg/m2 as obese. Furthermore, we considered if a fitted model for BMI and mortality could define a critical BMI tipping point for increasing mortality by the means of BMI categories of 1 kg/m2 width. We compared 29 pSCC patients with reported unintended weight loss at diagnosis to 400 with no reported weight loss. Cox regression with 95% confidence intervals was used for penile cancer-specific survival analysis. The comparison between 325 age-matched pSCC patients and 11,238 healthy men from an existing contemporary health database was done by nonparametric tests.RESULTS: There was no difference in cancer specific survival between patients with a BMI below and above 30 kg/m2, cox hazard ratio (HR) 0.74 (0.47-1.18), p = .20, but 37 kg/m2 was a tipping point for increasing mortality, HR = 2.10 (1.06-4.18), p = .035. Unintentional weight loss prior to diagnosis significantly predicted worse cancer specific outcome, cox hazard ratio 6.0 (3.5-10.0), p < 001 and cox hazard ratio adjusted for American Joint Committee of Cancer (AJCC)-stage at 1.8 (1.1-3.1), p = .03. Age-matched pSCC patients had a significantly higher BMI than healthy males, 28.4 ± 5.5 kg/m2 vs. 26.2 ± 3.6 kg/m2, p < .0001 and were more likely to smoke, p < .0001, and report alcohol intakes over 14 units/week, p < .0001.CONCLUSION: In this Danish cohort, BMI above 30 kg/m2 at diagnosis does not affect prognosis, but BMI at and above 37 kg/m2 at diagnosis predicts poor prognosis. Unintentional weight loss is a predictor of high stage and poor prognosis. PSCC patients have a significantly higher BMI than age-matched healthy males.

AB - BACKGROUND: Conflicting data on the prognostic significance of obesity in penile cancer have been presented in recent years.OBJECTIVE: The objective of this study was to investigate obesity as a prognostic factor in patients with penile squamous cell carcinoma (pSCC) in a large national Danish cohort. Furthermore we aimed to compare the BMI of pSCC patients to a large age-matched cohort of healthy men.METHODS: We evaluated 429 patients with invasive pSCC from a national retrospective penile cancer cohort and defined a body mass index (BMI) at 30 kg/m2 as obese. Furthermore, we considered if a fitted model for BMI and mortality could define a critical BMI tipping point for increasing mortality by the means of BMI categories of 1 kg/m2 width. We compared 29 pSCC patients with reported unintended weight loss at diagnosis to 400 with no reported weight loss. Cox regression with 95% confidence intervals was used for penile cancer-specific survival analysis. The comparison between 325 age-matched pSCC patients and 11,238 healthy men from an existing contemporary health database was done by nonparametric tests.RESULTS: There was no difference in cancer specific survival between patients with a BMI below and above 30 kg/m2, cox hazard ratio (HR) 0.74 (0.47-1.18), p = .20, but 37 kg/m2 was a tipping point for increasing mortality, HR = 2.10 (1.06-4.18), p = .035. Unintentional weight loss prior to diagnosis significantly predicted worse cancer specific outcome, cox hazard ratio 6.0 (3.5-10.0), p < 001 and cox hazard ratio adjusted for American Joint Committee of Cancer (AJCC)-stage at 1.8 (1.1-3.1), p = .03. Age-matched pSCC patients had a significantly higher BMI than healthy males, 28.4 ± 5.5 kg/m2 vs. 26.2 ± 3.6 kg/m2, p < .0001 and were more likely to smoke, p < .0001, and report alcohol intakes over 14 units/week, p < .0001.CONCLUSION: In this Danish cohort, BMI above 30 kg/m2 at diagnosis does not affect prognosis, but BMI at and above 37 kg/m2 at diagnosis predicts poor prognosis. Unintentional weight loss is a predictor of high stage and poor prognosis. PSCC patients have a significantly higher BMI than age-matched healthy males.

KW - Penile cancer

KW - cause specific survival

KW - mortality

KW - obesity

KW - prognosis

KW - squamous cell carcinoma

KW - weight loss

KW - MORTALITY

KW - CIRCUMCISION

KW - SMOKING

KW - TRENDS

KW - OBESITY

KW - MEN

KW - BODY-MASS INDEX

KW - PHYSICAL-ACTIVITY

U2 - 10.1080/21681805.2020.1803399

DO - 10.1080/21681805.2020.1803399

M3 - Journal article

C2 - 32772767

SN - 2168-1805

VL - 54

SP - 420

EP - 425

JO - Scandinavian Journal of Urology

JF - Scandinavian Journal of Urology

IS - 5

ER -

DaPeCa5 - obesity at the time of diagnosis does not predict poor cancer-specific survival in patients with penile squamous cell carcinoma - a Danish National study

Abstract

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