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Urology Xagena

Muscle-invasive urothelial carcinoma of the bladder: impact of BMI on the oncological outcomes of patients treated with radical cystectomy


Body mass index ( BMI ) has been associated with worse outcomes in several solid malignancies. A study has evaluated the association between BMI and oncological outcomes in patients treated with radical cystectomy for muscle-invasive urothelial carcinoma of the bladder ( UCB ).

Researchers have retrospectively reviewed 701 consecutive patients treated with radical cystectomy and pelvic lymphadenectomy for urothelial carcinoma of the bladder at Cochin Hospital ( Paris Descartes University, France ) between 1995 and 2011.
Univariable and multivariable Cox regression models investigated the association of BMI with disease recurrence and cancer-specific mortality. BMI was analyzed as both continuous and categorical variable ( less than 25 vs 25-29 vs greater than or equal to 30 kg/m2 ).

From the 701 patients, 275 ( 39.2% ) had a BMI less than 25 kg/m2, 280 ( 39.9% ) had a BMI between 25 and 29.9 kg/m2, and 146 ( 20.9%) had a BMI greater than or equal to 30 kg/m2.

Within a median follow-up of 45 months ( IQR 23-75 ), 163 patients ( 23.3% ) experienced a disease recurrence and 127 ( 18.1% ) died from the disease.

In univariable analyses, BMI greater than or equal to 30 kg/m2 was associated with a higher risk of disease recurrence and cancer-specific mortality ( both p values less than 0.01 ).

In multivariable analyses that adjusted for the effects of standard clinicopathological features, BMI greater than or equal to 30 kg/m2 was associated with both higher risks of disease recurrence ( hazard ratio, HR=1.58; 95 % CI 1.06-2.34, p = 0.02 ) and cancer-specific mortality ( HR=1.58; 95 % CI 1.01-2.48; p = 0.04).

In conclusion, obesity was independently associated with higher risks of disease recurrence and cancer-specific mortality in patients treated with radical cystectomy for muscle-invasive urothelial carcinoma of the bladder.
BMI is a modifiable feature that may have significant individual and public health implications in patients with muscle-invasive urothelial carcinoma of the bladder. ( Xagena )

Dabi Y et al, World J Urol 2016; Epub ahead of print

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