Unraveling the BMI paradox in different renal cortical tumors: insights from the INMARC registry.
Urol Oncol
; 42(4): 119.e1-119.e16, 2024 04.
Article
in En
| MEDLINE
| ID: mdl-38341362
ABSTRACT
OBJECTIVE:
To investigate impact of body mass index (BMI) on survival across different histologies and stages of renal cell carcinoma (RCC).METHODS:
We conducted a retrospective multicenter analysis of clear cell (ccRCC) and non-ccRCC. Obesity was defined according to the WHO criteria (non-Asian BMI >30 Kg/m2, Asian BMI >27.5 Kg/m2). Multivariable analysis (MVA) via Cox regression model was conducted for all-cause (ACM), cancer-specific mortality (CSM) and recurrence.RESULTS:
A total of 3,880 patients with a median follow-up of 31 (IQR 9-64) months were analyzed. Overall, 1,373 (35.3%) were obese; 2,895 (74.6%) were ccRCC and 985 (25.3%) were non-ccRCC (chRCC 246 [24.9%], pRCC 469 [47.6%] and vhRCC 270 [27.4%]). MVA in ccRCC revealed obesity associated with decreased risk of ACM, CSM and recurrence (hazard ratio [HR] 0.80, Pâ¯=â¯0.044; HR 0.71, Pâ¯=â¯0.039; HR 0.73, Pâ¯=â¯0.012, respectively), while in non-ccRCC was not associated with decreased risk of ACM, CSM, and recurrence (Pâ¯=â¯0.84, Pâ¯=â¯0.53, Pâ¯=â¯0.84, respectively). Subset analysis in stage IV ccRCC demonstrated obesity as associated with a decreased risk of ACM, CSM, and recurrence (HR 0.68, Pâ¯=â¯0.04; HR 0.59, Pâ¯=â¯0.01; HR 0.59, Pâ¯=â¯0.01, respectively), while in stage I-III ccRCC was not (Pâ¯=â¯0.21; Pâ¯=â¯0.30; Pâ¯=â¯0.19, respectively).CONCLUSION:
Our findings refute a broad "obesity paradox" for RCC. Obesity was not associated with improved survival in non-ccRCC and in nonmetastatic ccRCC, while metastatic ccRCC patients with obesity had improved survival outcomes.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Carcinoma, Renal Cell
/
Kidney Neoplasms
Type of study:
Prognostic_studies
Limits:
Humans
Language:
En
Journal:
Urol Oncol
Journal subject:
NEOPLASIAS
/
UROLOGIA
Year:
2024
Type:
Article