Quantifying the changes in body mass index and performance status during androgen deprivation therapy for advanced prostate cancer in southeast Nigeria

Abstract

Abstract Background Androgen deprivation therapy (ADT) for advanced prostate cancer (aPCa) causes changes in body mass index (BMI) and in the performance status depending on the extent of cancer remission. The aim of this study is to quantify these changes. Methods A prospective cohort study in a public tertiary urology centre in Enugu, southeast Nigeria. With appropriate sample size determined, men with aPCa for ADT, by surgical or medical modality, were recruited into a test group (TG), taking note of the Gleason score. A cohort of similar men without malignant or debilitating diseases formed the control group (CG). The age, weight and the Eastern Cooperative Oncology Group (ECOG) score were determined before ADT and at 2 monthly intervals for the TG. Same parameters were assessed for the CG at 2 monthly intervals. Additionally, total prostate-specific antigen (tPSA) was done for the TG at 3 monthly intervals. Results In all, 119 men in the TG and 68 men in the CG were recruited with no differences in age (F 2.777; p 0.10) and height (F 0.409; p 0.52) at recruitment. In the TG, BMI increased from 25.20 ± 3.92 to 26.26 ± 3.90 kg/m2 (p 0.001), median tPSA dropped from 36.9 ng/ml (IQR 20.4–65.7) to 3.7 ng/ml (IQR 1.1–8.7) and ECOG score improved (χ 2 34.1; df9; p 1 from 84.0 to 20.4%. A secondary finding is that gains in BMI and in ECOG score are earlier in the surgical modality than in the medical modality of ADT. Conclusions In the first 6 months of ADT, there are gains in BMI and ECOG scores. These gains are earlier with surgical modality of ADT.

Keywords

• Advanced prostate cancer
• Androgen deprivation therapy
• Body mass index
• ECOG score
• Performance status