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

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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.

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Availability of data and material

The datasets analyzed during the current study are available from the corresponding author upon reasonable request.

Code availability

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Acknowledgements

The authors would like to thank Professor Kung-Hao Liang from the Department of Medical Research at Taipei Veterans General Hospital for providing generous support as a statistical consultant.

Funding

This research was partially funded by Taipei Veterans General Hospital, Taiwan (V109C-176, V109EP-014, V110C-164, 110EP-009, V111C-196, 111EP-007) and the National Science and Technology Council, Taiwan (MOST 111-2221-E-075-003).

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Authors and Affiliations

  1. Department of Urology, Taipei Veterans General Hospital, No. 201, Sec. 2, Shipai Rd., Beitou Dist, Taipei, Taiwan

    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

  2. Department of Urology, College of Medicine and Shu-Tien Urological Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan

    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

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  1. Jen-Chieh Chen
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Contributions

J-CC: data analysis, manuscript writing. T-HH: data collection. T-CW: data collection. I-SH: Data collection. Y-HF: data collection. C-CL: data collection. T-PL: data collection. H-JC: data collection. S-HL: data collection. J-YK: data collection. HHHW: data collection. Y-HC: data collection. ATLL: data collection. WJH: data collection. EY-HH: project development, manuscript editing.

Corresponding author

Correspondence to Eric Yi-Hsiu Huang.

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The authors have no conflicts of interest to declare that are relevant to the content of this article.

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This study was approved by the Institutional Review Board/Ethics (IRB) Committee of Taipei Veterans General Hospital (IRB number: 2020-12-007BC).

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Chen, JC., Huang, TH., Wei, TC. et al. Influence of preoperative body mass index on prognosis for patients with upper urinary tract urothelial carcinoma treated with radical nephroureterectomy. World J Urol 41, 3575–3583 (2023). https://doi.org/10.1007/s00345-023-04685-5

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