Prognostic Implication of Body Mass Index on Survival Outcomes in Surgically Treated Nonmetastatic Renal Cell Carcinoma: A Single-Institutional Retrospective Analysis of a Large Cohort (original) (raw)

Abstract

Purpose

Obesity is a well-known risk factor for renal cell carcinoma (RCC). However, the prognostic role of obesity in RCC has not been clearly established thus far. We aim to assess the effect of preoperative body mass index (BMI) on survival outcomes in nonmetastatic RCC patients.

Patients and Methods

We retrospectively analyzed data on 2329 patients who underwent curative surgery for RCC between 2000 and 2014 in a single institution. Patients were divided into normal (< 23 kg/m2), overweight (23–24.9 kg/m2), and obese (≥ 25 kg/m2) groups depending on cutoffs for Asian population. Kaplan–Meier analysis with log-rank test was used to estimate and compare survival outcomes, including recurrence-free, overall, and cancer-specific survival, among each BMI group. The influence of BMI on each survival outcome was evaluated using multivariate Cox regression analyses.

Results

Obese patients presented favorable 5-year recurrent-free (90.7% vs 84.9%, p < 0.001), overall (91.8% vs 86.8%, p = 0.002), and cancer-specific (94.8% vs 89.4%, p = 0.002) survival rates than the normal group. Multivariate analyses revealed that increasing BMI was an independent predictor of favorable survival outcomes (all p values < 0.05). In particular, overweight (p = 0.009) and obese (p = 0.009) patients showed better cancer-specific survival compared with normal patients.

Conclusions

Our data suggest that overweight and obesity defined based on BMI are generally related to favorable survival outcomes after surgery for RCC. Additional basic research is required to find out the biological mechanisms explaining the correlation between BMI and survival outcomes.

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Acknowledgements

This work was supported by a National Research Foundation of Korea (NRF) Grant (Grant No. 2018R1C1B5086339) funded by the Korea Government (MSIP). The funding source had no role in the study design, data collection, data analysis, data interpretation, or the writing of this report. The corresponding author had full access to all data and final responsibility to submit the paper for publication.

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Authors and Affiliations

  1. Department of Urology, Seoul National University College of Medicine, Seoul, Korea
    Dong Young Seon MD, Cheol Kwak MD, PhD, Hyeon Hoe Kim MD, PhD & Ja Hyeon Ku MD, PhD
  2. Department of Urology, Dongguk University Ilsan Medical Center, Dongguk University College of Medicine, Goyang-si, Gyeonggi-do, Korea
    Hyung Suk Kim MD, PhD

Authors

  1. Dong Young Seon MD
  2. Cheol Kwak MD, PhD
  3. Hyeon Hoe Kim MD, PhD
  4. Ja Hyeon Ku MD, PhD
  5. Hyung Suk Kim MD, PhD

Contributions

Conception and design: HSK, JHK, CK, and HHK. Data acquisition: DYS and HSK. Data analysis and interpretation: DYS and HSK. Manuscript drafting: DYS and HSK. Critical revision of the manuscript for scientific and factual content: HSK, JHK, CK, and HHK. Statistical analysis: DYS and HSK. Supervision: HSK, JHK, CK, and HHK.

Corresponding author

Correspondence toHyung Suk Kim MD, PhD.

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No conflicts of interest were declared by all authors.

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Seon, D.Y., Kwak, C., Kim, H.H. et al. Prognostic Implication of Body Mass Index on Survival Outcomes in Surgically Treated Nonmetastatic Renal Cell Carcinoma: A Single-Institutional Retrospective Analysis of a Large Cohort.Ann Surg Oncol 27, 2459–2467 (2020). https://doi.org/10.1245/s10434-020-08417-6

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