Phase II prospective randomized trial of weight loss prior to radical prostatectomy

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Obesity is associated with poorly differentiated and advanced prostate cancer and increased mortality. In preclinical models, caloric restriction delays prostate cancer progression and prolongs survival. We sought to determine if weight loss (WL) in men with prostate cancer prior to radical prostatectomy affects tumor apoptosis and proliferation, and if WL effects other metabolic biomarkers.


In this Phase II prospective trial, overweight and obese men scheduled for radical prostatectomy were randomized to a 5–8 week WL program consisting of standard structured energy-restricted meal plans (1200–1500 Kcal/day) and physical activity or to a control group. The primary endpoint was apoptotic index in the radical prostatectomy malignant epithelium. Secondary endpoints were proliferation (Ki67) in the radical prostatectomy tissue, body weight, body mass index (BMI), waist to hip ratio, body composition, and serum PSA, insulin, triglyceride, cholesterol, testosterone, estradiol, leptin, adiponectin, interleukin 6, interleukin 8, insulin-like growth factor 1, and IGF binding protein 1.


In total 23 patients were randomized to the WL intervention and 21 patients to the control group. Subjects in the intervention group had significantly more weight loss (WL:−3.7 ± 0.5 kg; Control:−1.6 ± 0.5 kg; p = 0.007) than the control group and total fat mass was significantly reduced (WL:−2.1 ± 0.4; Control: 0.1 ± 0.3; p = 0.015). There was no significant difference in apoptotic or proliferation index between the groups. Among the other biomarkers, triglyceride, and insulin levels were significantly decreased in the WL compared with the control group.


In summary, this short-term WL program prior to radical prostatectomy resulted in significantly more WL in the intervention vs. the control group and was accompanied by significant reductions in body fat mass, circulating triglycerides, and insulin. However, no significant changes were observed in malignant epithelium apoptosis or proliferation. Future studies should consider a longer term or more intensive weight loss intervention.

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National Institute of Health P50CA92131 (WJA); Merit Review Award from the United States Department of Veterans Affairs. The contents do not represent the views of the U.S. Department of Veterans Affairs or the United States Government. Statistical analyses were supported by NIH/National Center for Advancing Translational Science (NCATS) UCLA CTSI Grant Number UL1TR001881 (TG/DE).

Author information


  1. Department of Urology, David Geffen School of Medicine, University of California-Los Angeles, Los Angeles, CA, 90095-1738, USA

    • Susanne M Henning
    • , Colette Galet
    • , Kiran Gollapudi
    • , Joshua B. Byrd
    • , Pei Liang
    •  & William J. Aronson
  2. Center for Human Nutrition, David Geffen School of Medicine, University of California-Los Angeles, Los Angeles, CA, 90024-2703, USA

    • Zhaoping Li
  3. Statistics Core, David Geffen School of Medicine, University of California-Los Angeles, Los Angeles, CA, 90095-1738, USA

    • Tristan Grogan
    •  & David Elashoff
  4. Department of Pathology, David Geffen School of Medicine, University of California-Los Angeles, Los Angeles, CA, 90095-1738, USA

    • Clara E. Magyar
    •  & Jonathan Said
  5. USC Davis School of Gerontology, Ethel Percy Andrus Gerontology Center University of Southern California, Los Angeles, 90089-0191, CA, USA

    • Pinchas Cohen
  6. VA Medical Center Greater Los Angeles Healthcare System, 11301 Whilshire Blvd, Los Angeles, 90073-1003, CA, USA

    • William J. Aronson


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Conflict of interest

The authors declare that they have no competing interest.

Corresponding author

Correspondence to William J. Aronson.