Influence of preoperative body mass index on prognosis for patients with upper urinary tract urothelial carcinoma treated with radical nephroureterectomy

Jen Chieh Chen, Tzu Hao Huang, Tzu Chun Wei, I. Shen Huang, Yu Hua Fan, Chih Chieh Lin, Tzu Ping Lin, Hsiao Jen Chung, Shing Hwa Lu, Junne Yih Kuo, Howard H.H. Wu, Yen Hwa Chang, Alex T.L. Lin, William J. Huang, Eric Yi Hsiu Huang

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)

Abstract

Purpose: The impact of body mass index (BMI) on patients with upper urinary tract urothelial carcinoma (UTUC) undergoing radical nephroureterectomy (RNU) is controversial. Increasing evidence suggests an age-dependent relationship between obesity and outcomes for some solid organ tumors. Herein, we aimed to assess the prognostic value of preoperative BMI in UTUC patients treated with RNU in Taiwan. Methods: This was a retrospective single-center study of 468 UTUC patients undergoing RNU during January 2010–December 2017, with preoperative BMI classification and subgroup analysis based on ages of < or ≥ 70 years. All UTUC patients underwent RNU and bladder cuff excision. Overall survival (OS), cancer-specific survival, and disease-free survival (DFS) were analyzed. Fisher’s exact test, Mann–Whitney U test, Kaplan–Meier method, and Cox regression model were used for data analysis. Results: The median follow-up duration was 36 months. Patients with higher versus lower BMI (cutoff: 25 kg/m2) showed no differences in OS; older patients had poor OS (hazard ratio [HR] 1.74; 95% confidence interval [CI] 1.24–2.40; p < 0.001). Older age was an independent predictor of poor OS in multivariate Cox regression analysis (p = 0.001). Younger patients with higher BMI (p = 0.02) had better DFS than older patients with no BMI-related survival differences. Higher BMI was an independent predictor of favorable DFS in younger patients in multivariate Cox regression analysis (HR, 0.53; 95% CI 0.28–0.99; p = 0.043). Conclusion: Younger UTUC patients with higher BMI were independently associated with a favorable DFS.

Original languageEnglish
Pages (from-to)3575-3583
Number of pages9
JournalWorld Journal of Urology
Volume41
Issue number12
DOIs
Publication statusAccepted/In press - 2023
Externally publishedYes

Keywords

  • Body mass index
  • Nephroureterectomy
  • Obesity paradox
  • Upper urinary tract urothelial carcinoma

ASJC Scopus subject areas

  • Urology

Fingerprint

Dive into the research topics of 'Influence of preoperative body mass index on prognosis for patients with upper urinary tract urothelial carcinoma treated with radical nephroureterectomy'. Together they form a unique fingerprint.

Cite this