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Obesity and prognosis in muscle‐invasive bladder cancer: The continuing controversy
Author(s) -
Kwon Taekmin,
Jeong In Gab,
You Dalsan,
Han KyungSik,
Hong Sungwoo,
Hong Bumsik,
Hong Jun Hyuk,
Ahn Hanjong,
Kim ChoungSoo
Publication year - 2014
Publication title -
international journal of urology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.172
H-Index - 67
eISSN - 1442-2042
pISSN - 0919-8172
DOI - 10.1111/iju.12530
Subject(s) - medicine , lymphovascular invasion , body mass index , cystectomy , overweight , bladder cancer , pathological , oncology , cancer , obesity , stage (stratigraphy) , urology , lymph node , metastasis , gastroenterology , paleontology , biology
Objectives To investigate the association between body mass index and clinicopathological features of bladder cancer, and to assess the prognostic value of body mass index in patients undergoing radical cystectomy for bladder cancer. Methods The medical records of 714 patients who underwent radical cystectomy for bladder cancer were reviewed. The association of body mass index at surgery with clinicopathological features was examined, and the prognostic value of body mass index for recurrence‐free survival and cancer‐specific survival was analyzed using the K aplan– M eier method and C ox regression models. Additional survival analyses were carried out in a subgroup of 534 patients with N0M0 disease. Results Of 714 patients, 304 (42.6%), 184 (25.8%) and 226 (31.7%) had a body mass index of <23 (normal), 23–25 (overweight), and ≥25 (obese) kg/m 2 , respectively. Patients with high body mass index had a lower pathological T stage, fewer lymph node metastases and a lower frequency of lymphovascular invasion than those with low body mass index ( P < 0.05). Multivariable analysis showed that obese status was an independent predictor of recurrence‐free survival (obese vs normal: P < 0.001; overweight vs normal: P = 0.008) and cancer‐specific survival (obese vs normal: P < 0.001; overweight vs normal: P = 0.019), along with pathological T stage, lymph node metastasis, and lymphovascular invasion. In addition, obesity was significantly associated with recurrence‐free survival ( P = 0.018) and cancer‐specific survival ( P = 0.019) in patients with N0M0 status. Conclusions The present findings suggest that overweight and obesity are associated with favorable pathological features and prognosis in patients with bladder cancer undergoing radical cystectomy.