Association between overweight and obesity determined by body mass index and overall survival in patients with metastatic prostate cancer: a meta-analysis.

BACKGROUND

Studies on the association between obesity and mortality in patients with prostate cancer have yielded inconclusive findings. This meta-analysis aimed to evaluate the association between overweight/obesity determined by body mass index (BMI) and overall survival (OS) in patients with metastatic prostate cancer (mPC).

METHODS

A systematic search was conducted in the PubMed, Web of Science, and Embase databases until February 2025. Studies that evaluated the association between overweight/obesity and OS in patients with mPC were considered.

RESULTS

Fifteen studies reported in 13 articles, including 18,280 patients, were identified. The overall pooled adjusted HR for OS was 0.79 (95% CI 0.73-0.85) for patients with overweight/obesity versus those with normal weight. The pooled adjusted HR for OS was 0.81(95%CI 0.75-0.87) for overweight and 0.78 (95%CI 0.67-0.90) for obesity. Furthermore, the association of overweight (HR 0.78; 95% CI 0.71-0.85) and obesity (HR 0.73; 95% CI 0.59-0.90) with OS was more pronounced in patients with metastatic castration-resistant prostate cancer (mCRPC). Additionally, each 1-unit increase in BMI was associated with a 4% (95% CI 1.0-8.0%) improvement in OS.

CONCLUSION

Patients with mPC who have overweight or obesity, as defined by BMI, are associated with improved overall survival, particularly in those with mCRPC.