Body mass index and survival in patients with renal cell carcinoma: A clinical-based cohort and meta-analysis
- Authors
- Choi, Yuni; Park, Bumsoo; Jeong, Byong Chang; Il Seo, Seong; Jeon, Seong Soo; Choi, Han Yong; Adami, Hans-Olov; Lee, Jung Eun; Lee, 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
- Pages
- 10
- 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
1097-0215
- 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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