Periprostatic Adiposity Measured on Magnetic Resonance Imaging Correlates with Prostate Cancer Aggressiveness

Purpose: To evaluate the correlation between aggressiveness of prostate cancer (PCa) and obesity measuring the periprostatic fat on magnetic resonance imaging (MRI). Materials and Methods: One hundred eighty-four patients who had undergone radical retropubic prostatectomy (RRP) were analyzed retrospectively. The different fat measurements (periprostatic fat area (PFA), the subcutaneous fat thickness, the anterior and posterior abdominal fat thicknesses and anteroposterior diameter) were performed on the slices of MRI and then compared with the clinical and pathologic characteristics. Results: The PFA and ratio showed a statistically significant differences (P = .019 and P = .025, respectively) among three groups, that is to say, more adipose were distributed in periprostatic area of the high risk patients. Seventy-one patients in clinical stage and 82 patients in Gleason score have the significant differences between pre-operation and post-operation values. In the clinical stage, the PFA and ratio showed a statistically significant differences (P = .014 and P = .037, respectively). The difference group had more periprostatic adipose than the other one (65.26 ± 9.03 vs. 64.44 ± 9.62; 87.52 ± 3.97 vs. 87.30 ± 3.96). Nothing but the “PFA” was significantly different between two groups (P = .017). Logistic regression analysis adjusted for age revealed a statistically significant association between the PFA, the Ratio and the risk of having high-risk disease (P = .031 and P = .024, respectively). Conclusion: The periprostatic adiposity not only affects the PCa aggressiveness, but also has effect in accurate assessment of the tumor stage and grade. We should predict the prognosis of patient with RRP by measuring periprostatic adiposity on pre-operative MRI.