Prostatic fatty acids and cancer recurrence after radical prostatectomy for early-stage prostate cancer.

Objective: Results from some observational studies suggest that diet and energy balance influence the clinical course of early-stage prostate cancer. To evaluate possible mechanisms, we prospectively examined the relation between prostatic concentrations of fatty acids at diagnosis and cancer recurrence following primary therapy.

Methods: Fatty acids were measured by capillary gas chromatography in fresh, non-cancerous prostate tissue collected from 184 men undergoing radical prostatectomy for clinically localized prostate cancer. Their association with risk of biochemical disease recurrence (a rising serum prostate-specific antigen following a disease-free [<0.1 ng/ml] interval > or =6 months) was analyzed using Cox proportional hazards models incorporating patient age, body mass index, tumor characteristics at diagnosis, and ethnicity.

Results: During an average follow-up of 48.7 months (median = 47), 14 patients experienced biochemical recurrence. Percent total polyunsaturated fatty acid and the ratio of oleic-to-stearic acid associated with risk (multivariable hazards ratio [HR] = 0.51, 95% confidence interval [CI] = 0.29 to 0.90, p = 0.021 and HR = 1.68, 95% CI = 1.21 to 2.33, p = 0.002, respectively, per 1 standard deviation increase).

Conclusions: The results of this study are preliminary, but they suggest that pre-diagnostic prostatic concentrations of fatty acids associate with risk of biochemical recurrence following radical prostatectomy for clinically localized prostate cancer.