Dabi Y, et al. - The authors probed into the link between body mass index (BMI) and oncological outcomes, in patients treated with radical nephroureterectomy (RNU) for upper tract urothelial carcinoma (UTUC). An independent connection was determined between obesity with higher risks of disease recurrence and cancer-specific mortality in the study cohort.

Methods

• The enrollment comprised of 237 consecutive patients treated with RNU for UTUC, treated between 1990 and 2012.
• Univariable and multivariable cox regression models were applied in order to analyze the link between BMI with disease recurrence, cancer-specific mortality, and overall mortality.

Results

• Among the 237 patients, 104 (44%) reported 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.
• 53 patients (22.4%) presented with a disease recurrence, 85 patients (35.9%) had bladder recurrence, and 44 patients (18.6%) died from the disease, within a median follow-up of 44 months (IQR: 24-79).
• 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.
• The multivariable analyses that adjusted for the effects of the standard clinico-pathological features revealed that BMI ≥ 30 kg/m² was linked to 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).