Table 1 Main characteristics of the studies included in the systematic review
References | Objective | Design | Number of patients | Follow-up (months) | QOL scale | QOL evaluation before treatment | BMI categorization (kg/m2) | Nerve-sparing status | Patient age | Tumor stage | Comorbidities | Timing and function affected by high BMI | |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
1 | Freedland S. [31] | Impact of obesity on QOL after prostatectomy | American, prospective, single-center | 340 | 24 | UCLA-PCI | Yes | ≤ 25, 25–30, 30–35 | Bilateral = 257, unilateral = 68, none = 15 | Mean (SD): 56.1 (NA) | T1c-T3a | NA | Urinary function after 24 months |
2 | Anast J. [11] | Impact of obesity on QOL after prostatectomy | American, retrospective, multicenter | 1884 | 24 | UCLA-PCI, SF-36 | Yes | ≤ 25, 25–30, 30–35, ≥ 35 | NA | Mean (SD): 61.5 (NA) | T1-T3 | Number of comorbidities (0–1, 2–4) | Physical function, general health, and vitality after 24 months |
3 | Dess R. [13] | Impact of radiotherapy on erectile function | American, prospective, single-center | 373 | 56 | EPIC-26, IIEF-5 | Yes | ≤ 30, 30–40, ≥ 40 | NA | Median (IQR): 69 (64, 73) | T1c-T3 | Diabetes, hypertension, coronaropathy, depression | Sexual function after 60 months |
4 | Latini D. [38] | Impact of diabetes on QOL after prostatectomy | American, prospective, multicenter | 1248 | 24 | UCLA-PCI | Yes | ≤ 25, 25–30, 30-35 | NA | ≤ 65: 810, ≥ 65: 438 | T1-T3 | Number of comorbidities (0, 1–2, 3 +) | Urinary function after 24 months |
5 | Thomas R. [25] | Impact of obesity on pelvic symptoms post-radiotherapy | English, retrospective, single-center | 440 | 43 | CTCAE, Vaizey rectal symptoms score | No | ≤ 18.5, 18.5–25, 25–30, ≥ 30 | NA | Mean (min, max): 74 (53, 94) | NA | NA | Rectal symptoms and nycturia after 43 months (median) |
6 | Dieperink K. [20] | Study of QOL after radiotherapy and hormone therapy | Danish, retrospective, single-center | 317 | Maximum 48 months | SF-12, EPIC-26 | No | ≤ 30, ≥ 30 | NA | Mean (min, max): 65.7 (48, 77) | T1-T3 | NA | Urinary symptoms and vitality between 12 and 48 months after treatment |
7 | Montgomery J. [37] | Impact of obesity on QOL after prostatectomy | American, prospective, single-center | 376 | 36 | SF-12, EPIC-26 | Yes | ≤ 25, 25–30, 30–35, ≥ 35 | NA | Mean (SD): 59.2 (NA) | T1-T2 | Number of comorbidities (0–1, 2–3, 4 +) | Poorer bowel function after 24 months, if adjuvant radiotherapy |
8 | Sanda M. [19] | Study of QOL after local treatment (prostatectomy, radiotherapy or brachytherapy) | American, prospective, multicenter | 1201 | 24 | EPIC-26, SCA, SCA-P, EPIC-Partner | Yes | Median: 28 | Yes | Median (min, max): 63 (38, 84) | T1-T2 | Number of comorbidities | Vitality and hormonal function 6 months or later after treatment |
9 | Wiltz A. [12] | Impact of obesity on QOL after prostatectomy | American, prospective, single-center | 945 | 24 | UCLA-PCI, SF-36, IIEF-5, IPSS | Yes | ≤ 25, 25–30, 30–35 | Yes | Mean (SD): 59.8 (NA) | T1c-T3b | Diabetes, hypertension, coronaropathy | Urinary and sexual function after 12 and 24 months |
10 | Merrick G. [10] | Impact of obesity on QOL after prostatic brachytherapy | American, retrospective, single-center | 32 | 28 | IPSS, IIEF, R-FAS | Yes | ≥ 35 | NA | Mean (SD): 63.8 (6.5) | T1c-T2b | NA | No difference |
11 | Ferenc S. [18] | Study of QOL after brachytherapy | Polish, retrospective, single-center | 49 | 2 | Numerical scale | No | 19–25, ≥ 25 | NA | Mean (SD): 66.9 (10.3) | NA | NA | Less urinary incontinence at the end of treatment |
12 | Alemozaffar M. [15] | Study of sexual function after local treatment (prostatectomy, radiotherapy or brachytherapy) | American, prospective, multicenter | 1027 | 24 | EPIC-26 | Yes | ≤ 25, 25–35, ≥ 35 | Yes | Mean (SD): 66 (NA) | T1-T2 | NA | Sexual function after 24 months |
13 | Abdollah F. [14] | Study of urinary incontinence after prostatectomy | Italian, prospective, single-center | 1311 | 12 | ICIQ-SF6, IIEF | Yes | ≤ 25, ≥ 25 | Yes | Mean (min, max): 62.6 (38.9, 80) | ≥ T1c | Charlson Index | Urinary incontinence if age < 65, after 3, 6 and 12 months |
14 | Haahr M. [24] | Study of sexual function after prostatectomy | Danish, retrospective, single-center | 704 | 12 | IIEF-5 | Yes | ≤ 25, 25–30, ≥ 30 | Yes | Mean (SD): 62 (5.8) | T1-T3b | Hypertension, diabetes, ASA score, dyslipidemia | Sexual function after 12 months |
15 | Garg T. [23] | Impact of obesity on sexual and urinary function after prostatectomy | American, retrospective, single-center | 691 | 36 | SHIM, IIQ-7, Bladder Health Questionnaire | Yes | ≤ 18.5, 18.5–25, 25–30 | Yes | Mean (SD): 59.1 (6.4) | T2a-T3b | Diabetes, hypertension, coronaropathy | No difference |
16 | Limani K. [16] | Impact of BMI on QOL after prostatectomy | Belgian, retrospective, single-center | 272 | 24 | ICIQ-UI SF, EORTC QLQ PR25 | Yes | ≤ 30, ≥ 30 | Yes | Mean (SD): 63 (6) | NA | NA | No difference |
17 | Chen S. [22] | Study of urinary function after local treatment (prostatectomy or radiotherapy) | Taiwanese, prospective, multicenter | 131 | 12 | IPSS | Yes | NA | NA | Mean (SD): 68.77 (9.29) | T1-T3 | NA | Urinary function after 3 months |
18 | Cozzi G. [30] | Study of erectile function 1 year after prostatectomy | Italian, retrospective, single-center | 643 | 12 | EPIC | Yes | ≤ 25, 25–30, ≥ 30 | Yes | < 60: 26%, 60–70: 54%, > 70: 20% | T1-T3 | Charlson Index | No difference |
19 | Koneru H. [17] | Impact of obesity on QOL after radiotherapy | American, retrospective, single-center | 266 | 24 | EPIC-26 | Yes | ≤ 25, 25–30, 30–35, 35–40, ≥ 40 | NA | Median (min, max): 69 (44, 94) | NA | Charlson Index | Sexual function after 24 months and fatigue after 18 months |
20 | Challapalli A. [21] | Study of vasomotor symptoms during hormone therapy | English, prospective, single-center | 250 | 9 | Vasomotor symptoms scale | No | Median BMI: 28 | NA | Mean (SD): 74 (NA) | T1-T4, N0-N1, M0-M1 | Hypertension, diabetes, myocardial infarction | Vasomotor symptoms after 9 months |