OBJECTIVE: To examine the association between the body mass index (BMI) and the risk of survival, and to evaluate whether tumor characteristics differ by BMI in patients with upper tract urothelial carcinoma (UTUC) managed by surgery. METHODS: A clinical series on 876 patients with localized UTUC following nephroureterectomy with a bladder cuff, with data from Osaka Medical College registry (discovery cohort) and the Nagoya group (validation cohort) was examined. In addition to analyzing the overall survival and cancer-specific survival (CSS), the survival impact adjusted by pathological variables was also assessed by the BMI group. RESULTS: The percentage of high risk features including positive lymphovascular invasion was doubled in the discovery cohort compared to the validation cohort. The group of BMI ≥ 25 kg/m<sup>2</sup> was associated with improved CSS in the discovery cohort (p = 0.004), and this tendency was verified in the validation cohort (p = 0.006). Nonproportional hazards existed for the group of BMI ≥ 25 kg/m<sup>2</sup> and the BMI 18.5-25 kg/m<sup>2</sup> relative to the group of BMI < 18.5 kg/m<sup>2</sup>, with a change in the CSS hazard. In multivariable Cox models, the BMI group had a superior predictive value compared with other pre-clinical factors both in the discovery cohort (HR = 3.85, p = 0.01; 95%CI: 0.09-0.73) and the validation cohort (HR = 1.56, p = 0.01; 95%CI: 0.45-0.91). When adjusted by lymphovascular invasion, the concordance of the model proposed by the discovery cohort (0.52) challenged in the validation cohort was 0.59. CONCLUSIONS: We found a clinically relevant signature for high risk patients with BMI grouping. Further research is necessary on whether tailoring recommendations for weight and nutrition management to tumor characteristics will improve outcomes.
OBJECTIVE: To examine the association between the body mass index (BMI) and the risk of survival, and to evaluate whether tumor characteristics differ by BMI in patients with upper tract urothelial carcinoma (UTUC) managed by surgery. METHODS: A clinical series on 876 patients with localized UTUC following nephroureterectomy with a bladder cuff, with data from Osaka Medical College registry (discovery cohort) and the Nagoya group (validation cohort) was examined. In addition to analyzing the overall survival and cancer-specific survival (CSS), the survival impact adjusted by pathological variables was also assessed by the BMI group. RESULTS: The percentage of high risk features including positive lymphovascular invasion was doubled in the discovery cohort compared to the validation cohort. The group of BMI ≥ 25 kg/m<sup>2</sup> was associated with improved CSS in the discovery cohort (p = 0.004), and this tendency was verified in the validation cohort (p = 0.006). Nonproportional hazards existed for the group of BMI ≥ 25 kg/m<sup>2</sup> and the BMI 18.5-25 kg/m<sup>2</sup> relative to the group of BMI < 18.5 kg/m<sup>2</sup>, with a change in the CSS hazard. In multivariable Cox models, the BMI group had a superior predictive value compared with other pre-clinical factors both in the discovery cohort (HR = 3.85, p = 0.01; 95%CI: 0.09-0.73) and the validation cohort (HR = 1.56, p = 0.01; 95%CI: 0.45-0.91). When adjusted by lymphovascular invasion, the concordance of the model proposed by the discovery cohort (0.52) challenged in the validation cohort was 0.59. CONCLUSIONS: We found a clinically relevant signature for high risk patients with BMI grouping. Further research is necessary on whether tailoring recommendations for weight and nutrition management to tumor characteristics will improve outcomes.
Authors: Behfar Ehdaie; Thomas F Chromecki; Richard K Lee; Yair Lotan; Vitaly Margulis; Pierre I Karakiewicz; Giacomo Novara; Jay D Raman; Casey Ng; William T Lowrance; Douglas S Scherr; Shahrokh F Shariat Journal: J Urol Date: 2011-05-14 Impact factor: 7.450
Authors: Massimiliano D'Aiuto; Andrea Chirico; Michele Antonio De Riggi; Giuseppe Frasci; Michelino De Laurentiis; Maurizio Di Bonito; Patrizia Vici; Laura Pizzuti; Domenico Sergi; Marcello Maugeri-Saccà; Maddalena Barba; Antonio Giordano Journal: Cancer Biol Ther Date: 2016-03-02 Impact factor: 4.742
Authors: Tobias Maurer; Jean Maurer; Margitta Retz; Roger Paul; Niko Zantl; Jurgen E Gschwend; Uwe Treiber Journal: Urol Int Date: 2009-06-08 Impact factor: 2.089
Authors: G Berclaz; S Li; K N Price; A S Coates; M Castiglione-Gertsch; C-M Rudenstam; S B Holmberg; J Lindtner; D Erien; J Collins; R Snyder; B Thürlimann; M F Fey; C Mendiola; I Dudley Werner; E Simoncini; D Crivellari; R D Gelber; A Goldhirsch Journal: Ann Oncol Date: 2004-06 Impact factor: 32.976