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Body mass index and survival in patients with renal cell carcinoma: A clinical-based cohort and meta-analysis

Authors
Choi, YuniPark, BumsooJeong, Byong ChangIl Seo, SeongJeon, Seong SooChoi, Han YongAdami, Hans-OlovLee, Jung EunLee, Hyun Moo
Issue Date
1-Feb-2013
Publisher
WILEY
Keywords
renal cell carcinoma; body mass index; survival; meta-analysis
Citation
INTERNATIONAL JOURNAL OF CANCER, v.132, no.3, pp.625 - 634
Journal Title
INTERNATIONAL JOURNAL OF CANCER
Volume
132
Number
3
Start Page
625
End Page
634
URI
https://scholarworks.sookmyung.ac.kr/handle/2020.sw.sookmyung/11343
DOI
10.1002/ijc.27639
ISSN
0020-7136
Abstract
Growing evidence suggests that obesity, an established cause of renal cell cancer (RCC), may also be associated with a better prognosis. To evaluate the association between RCC survival and obesity, we analyzed a large cohort of patients with RCC and undertook a meta-analysis of the published evidence. We collected clinical and pathologic data from 1,543 patients who underwent nephrectomy for RCC between 1994 and 2008 with complete follow-up through 2008. Patients were grouped according to BMI (kg/m2): underweight <18.5, normal weight 18.5 to <23, overweight 23 to <25 and obese =25. We estimated survival using the KaplanMeier method and Cox proportional hazard models to examine the impact of BMI on overall survival (OS) and cancer-specific survival (CSS) with adjustment for covariates. We performed a meta-analysis of BMI and OS, CSS and recurrence-free survival (RFS) from all relevant studies using a random-effects model. The 5-year CSS increased from 76.1% in the lowest to 92.7% in the highest BMI category. A multivariate analysis showed higher OS [hazard ratio (HR) = 0.45; 95% CI: 0.290.68) and CSS (HR = 0.47; 95% CI: 0.290.77] in obese patients than in normal weight patients. The meta-analysis further corroborated that high BMI significantly improved OS (HR = 0.57; 95% CI: 0.430.76), CSS (HR = 0.59; 95% CI: 0.480.74) and RFS (HR = 0.49; 95% CI: 0.300.81). Our study shows that preoperative BMI is an independent prognostic indicator for survival among patients with RCC.
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