Bassel G Bachir1, Armen G Aprikian1, Jonathan I Izawa2, Joseph L Chin2, Yves Fradet3, Adrian Fairey4, Eric Estey4, Niels Jacobsen4, Ricardo Rendon5, Ilias Cagiannos6, Louis Lacombe3, Jean-Baptiste Lattouf7, Anil Kapoor8, Edward Matsumoto8, Fred Saad7, David Bell5, Peter C Black9, Alan I So9, Darrel Drachenberg10, Wassim Kassouf11. 1. Department of Surgery (Urology), McGill University, Montreal, Quebec, Canada. 2. Department of Surgery (Urology), Western University, London, Ontario, Canada. 3. Department of Surgery (Urology), Laval University, Quebec City, Quebec, Canada. 4. Department of Surgery (Urology), University of Alberta, Edmonton, Alberta, Canada. 5. Department of Surgery (Urology), Dalhousie University, Halifax, Nova Scotia, Canada. 6. Department of Surgery (Urology), University of Ottawa, Ottawa, Ontario, Canada. 7. Department of Surgery (Urology), University of Montreal, Montreal, Quebec, Canada. 8. Department of Surgery (Urology), McMaster University, Hamilton, Ontario, Canada. 9. Department of Surgery (Urology), University of British Columbia, Vancouver, British Columbia, Canada. 10. Department of Surgery (Urology), University of Manitoba, Winnipeg, Manitoba, Canada. 11. Department of Surgery (Urology), McGill University, Montreal, Quebec, Canada. Electronic address: wassim.kassouf@muhc.mcgill.ca.
Abstract
OBJECTIVE: To evaluate the effect of body mass index (BMI) on the outcomes of patients with urinary tract carcinoma treated with radical surgery. MATERIALS AND METHODS: Data were collected from 10 Canadian centers on patients who underwent radical cystectomy (RC) (1998-2008) or radical nephroureterectomy (RNU) (1990-2010). Various parameters among subsets of patients (BMI < 25, 25 ≤ BMI < 30, and BMI ≥ 30 kg/m(2)) were analyzed. Kaplan-Meier and multivariate analyses were performed to assess the effect of BMI on overall survival, disease-specific survival, and recurrence-free survival (RFS). RESULTS: Among the 847 RC and 664 RNU patients, there was no difference in histology, stage, grade, and margin status among the 3 patient subsets undergoing either surgery. However, RC patients with lower BMIs (< 25 kg/m(2)) were significantly older (P = 0.004), had more nodal metastasis (P = 0.03), and trended toward higher stage (P = 0.052). RNU patients with lower BMIs (< 25 kg/m(2)) were significantly older (P = 0.0004) and fewer received adjuvant chemotherapy (P = 0.04) compared with those with BMI ≥ 30 kg/m(2); however, there was no difference in tumor location (P = 0.20), stage (P = 0.48), and management of distal ureter among the groups (P = 0.30). On multivariate analysis, BMI was not prognostic for overall survival, disease-specific survival, and RFS in the RC group. However, BMI ≥ 30 kg/m(2) was associated with more bladder cancer recurrences and worse RFS in the RNU group (HR = 1.588; 95% CI: 1.148-2.196; P = 0.0052). CONCLUSIONS: Increased BMI did not influence survival among RC patients. BMI ≥ 30 kg/m(2) is associated with worse bladder cancer recurrences among RNU patients; whether this is related to difficulty in obtaining adequate bladder cuff in patients with obesity requires further evaluation.
OBJECTIVE: To evaluate the effect of body mass index (BMI) on the outcomes of patients with urinary tract carcinoma treated with radical surgery. MATERIALS AND METHODS: Data were collected from 10 Canadian centers on patients who underwent radical cystectomy (RC) (1998-2008) or radical nephroureterectomy (RNU) (1990-2010). Various parameters among subsets of patients (BMI < 25, 25 ≤ BMI < 30, and BMI ≥ 30 kg/m(2)) were analyzed. Kaplan-Meier and multivariate analyses were performed to assess the effect of BMI on overall survival, disease-specific survival, and recurrence-free survival (RFS). RESULTS: Among the 847 RC and 664 RNU patients, there was no difference in histology, stage, grade, and margin status among the 3 patient subsets undergoing either surgery. However, RC patients with lower BMIs (< 25 kg/m(2)) were significantly older (P = 0.004), had more nodal metastasis (P = 0.03), and trended toward higher stage (P = 0.052). RNU patients with lower BMIs (< 25 kg/m(2)) were significantly older (P = 0.0004) and fewer received adjuvant chemotherapy (P = 0.04) compared with those with BMI ≥ 30 kg/m(2); however, there was no difference in tumor location (P = 0.20), stage (P = 0.48), and management of distal ureter among the groups (P = 0.30). On multivariate analysis, BMI was not prognostic for overall survival, disease-specific survival, and RFS in the RC group. However, BMI ≥ 30 kg/m(2) was associated with more bladder cancer recurrences and worse RFS in the RNU group (HR = 1.588; 95% CI: 1.148-2.196; P = 0.0052). CONCLUSIONS: Increased BMI did not influence survival among RC patients. BMI ≥ 30 kg/m(2) is associated with worse bladder cancer recurrences among RNU patients; whether this is related to difficulty in obtaining adequate bladder cuff in patients with obesity requires further evaluation.
Authors: Sarah P Psutka; Stephen A Boorjian; Michael R Moynagh; Grant D Schmit; Igor Frank; Alonso Carrasco; Suzanne B Stewart; Robert Tarrell; Prabin Thapa; Matthew K Tollefson Journal: J Urol Date: 2014-11-22 Impact factor: 7.450
Authors: Ho Won Kang; Hae Do Jung; Yun-Sok Ha; Tae-Hwan Kim; Tae Gyun Kwon; Seok-Soo Byun; Seok-Joong Yun; Wun-Jae Kim; Young Deuk Choi Journal: J Korean Med Sci Date: 2015-09-12 Impact factor: 2.153
Authors: Ellen Westhoff; J Alfred Witjes; Neil E Fleshner; Seth P Lerner; Shahrokh F Shariat; Gunnar Steineck; Ellen Kampman; Lambertus A Kiemeney; Alina Vrieling Journal: Bladder Cancer Date: 2018-01-20