The effect of abdominal visceral fat amount measured in computed tomography on prostate cancer gleason score

Introduction: Prostate cancer stands out as the second most common cancer in the male gender. Obesity is also held responsible in the etiology of prostate cancer, as in many diseases. BMI is used as the most important indicator of obesity in studies. However, BMI shows general adiposity and does not classify adipose tissue and lean mass, especially in men with muscle mass. It does not show the abdominal fat distribution. For this reason, visceral and subcutaneous fat tissue measurements in cross-sectional abdominal images are being used more frequently in the determination of obesity. Materials and Methods: In the study, the data of patients diagnosed and followed up for prostate cancer between 01.2012 and 12.2020 were scanned. Among these patients, 276 patients who had not received any treatment for PCa before and who had cross-sectional abdominal imaging for any reason within 6 months before and after diagnosis were included in the study. PSA values and ISUP scores of the patients were obtained. Total gleason scores were grouped as <8 and ≥8, D'Amico and NCCN risk groups were determined. Visceral (VFA), subcutaneous (SFA) and total (TFA) fat amounts, waist circumference, subcutaneous and visceral (VAT) region and total AP measurements were made in the axial sections taken from the L4 vertebra level of these patients. The relative visceral fat ratio (rVFA) of the patients was calculated. These anthropometric measurements were compared with PSA, ISUP, Gleason score (<8, ≥8), D'Amico risk group and NCCN risk group. Group relations were evaluated using One Way ANOVA, Kruskal Wallis H test, chi-square test and Spearman correlation test. Statistical significance level was taken as 0.05. Results: The mean age of 276 patients included in the study was 68.32±7.54 years. Comorbid diseases were not associated with D'Amico and NCCN risk groups. When the measured VFA, rVFA, VAT/AP and waist circumference parameters were compared with the patients' PSA value, ISUP grade, D'Amico and NCCN risk groups, an increase in waist circumference and a statistically significant decrease in PSA value were detected (p=0.029). No significant correlation was found between any of the other obesity parameters and prostate cancer risk groups. Conclusion: As a result of the measurements targeting the visceral obesity and waist circumference parameters, which are among the important markers of obesity, no relationship was found between these parameters and prostate cancer stage and risk groups. However, although there are conflicting results in this regard, it is known that obesity has a direct or indirect effect on prostate cancer. It is obvious that the relationship between obesity and prostate cancer, which is one of the most common cancer types today, needs to be clarified clearly. For this purpose, it is necessary to overcome the biases found in the study and to conduct prospective studies with large series. Keywords: Prostate Cancer, obesity, visceral obesity, waist circumference, computed tomography, risk factors