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Impact of body mass index on the oncological outcomes of patients treated with radical nephroureterectomy for upper tract urothelial carcinoma

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Abstract

Purpose

To evaluate the association between body mass index (BMI) and oncological outcomes in patients treated with radical nephroureterectomy (RNU) for upper tract urothelial carcinoma (UTUC).

Methods

We retrospectively reviewed 237 consecutive patients treated with RNU for UTUC at our institution between 1990 and 2012. Univariable and multivariable cox regression models investigated the association of BMI with disease recurrence, cancer-specific mortality, and overall mortality.

Results

From the 237 patients, 104 (44%) had a BMI < 25 kg/m2, 88 (37%) had a BMI between 25 and 29.9 kg/m2, and 45 (19%) had a BMI ≥ 30 kg/m2 at the time of surgery. Within a median follow-up of 44 months (IQR: 24–79), 53 patients (22.4%) experienced a disease recurrence, 85 patients (35.9%) had bladder recurrence, and 44 patients (18.6%) died from the disease. The 5 year recurrence-free and cancer-specific survival rates were, respectively, 32 and 56% for BMI ≥ 30 kg/m2, 45 and 74% for patients with BMI 25–29.9 kg/m2, and 69 and 81% for patients with BMI < 25 kg/m2. In multivariable analyses that adjusted for the effects of the standard clinico-pathological features, BMI ≥ 30 kg/m2 was associated with a higher risk of disease recurrence (HR 3.23; 95% CI 2.3–6.6, p < 0.001) and cancer-specific mortality (HR 3.84; 95% CI 2.8–6.5; p < 0.001).

Conclusions

Obesity was independently associated with higher risks of disease recurrence and cancer-specific mortality in patients treated with RNU for UTUC.

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Author information

Authors and Affiliations

  1. Department of Urology, Cochin Hospital, Assistance Publique Hôpitaux de Paris, Paris Descartes University, 27, rue du Faubourg Saint-Jacques, 75014, Paris, France

    Yohann Dabi, Mohammed El Mrini, Igor Duquesnes, Nicolas Barry Delongchamps, Marc Zerbib & Evanguelos Xylinas

  2. Department of Pathology, Cochin Hospital, Assistance Publique Hôpitaux de Paris, Paris Descartes University, Paris, France

    Mathilde Sibony

Authors
  1. Yohann Dabi
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  2. Mohammed El Mrini
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  3. Igor Duquesnes
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  4. Nicolas Barry Delongchamps
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  5. Mathilde Sibony
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  6. Marc Zerbib
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  7. Evanguelos Xylinas
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Contributions

YD: data analysis and manuscript writing. MEM: data management/project development. ID: manuscript writing. NBD: data analysis. MS: data collection. MZ: data collection/manuscript editing. EX: project development, data analysis, and manuscript editing

Corresponding author

Correspondence to Evanguelos Xylinas.

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Ethical approval

For this type of study, formal consent is not required. Informed consent was obtained from all individual participants included in the study. The study was approved by our local Ethic Committee.

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Dabi, Y., El Mrini, M., Duquesnes, I. et al. Impact of body mass index on the oncological outcomes of patients treated with radical nephroureterectomy for upper tract urothelial carcinoma. World J Urol 36, 65–71 (2018). https://doi.org/10.1007/s00345-017-2095-4

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  • DOI: https://doi.org/10.1007/s00345-017-2095-4

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