Top

Published in:

01-02-2017 | Original Article

Impact of body mass index on the oncological outcomes of patients treated with radical cystectomy for muscle-invasive bladder cancer

Authors: Yohann Dabi, Yohann Rouscoff, Julien Anract, Nicolas Barry Delongchamps, Mathilde Sibony, Djillali Saighi, Marc Zerbib, Michael Peyraumore, Evanguelos Xylinas

Published in: World Journal of Urology | Issue 2/2017

Abstract

Purpose

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

Methods

We retrospectively reviewed 701 consecutive patients treated with RC and pelvic lymphadenectomy for UCB at our institution 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 (<25 vs. 25–29 vs. ≥30 kg/m²).

Results

From the 701 patients, 275 (39.2 %) had a BMI < 25 kg/m², 280 (39.9 %) had a BMI between 25 and 29.9 kg/m², and 146 (20.9 %) had a BMI ⩾ 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 ⩾ 30 kg/m² was associated with a higher risk of disease recurrence and cancer-specific mortality (both p values <0.01). In multivariable analyses that adjusted for the effects of standard clinicopathological features, BMI ⩾ 30 kg/m² was associated with both higher risks of disease recurrence (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).

Conclusions

Obesity was independently associated with higher risks of disease recurrence and cancer-specific mortality in patients treated with RC for muscle-invasive UCB. BMI is a modifiable feature that may have significant individual and public health implications in patients with muscle-invasive UCB.

Rouprêt M, Babjuk M, Compérat E et al (2015) European association of urology guidelines on upper urinary tract urothelial cell carcinoma: 2015 update. Eur Urol 68:868–879. doi:10.1016/j.eururo.2015.06.044 CrossRefPubMed

Wolk A, Gridley G, Svensson M et al (2001) A prospective study of obesity and cancer risk (Sweden). CCC 12:13–21PubMed

Chromecki TF, Cha EK, Fajkovic H et al (2013) Obesity is associated with worse oncological outcomes in patients treated with radical cystectomy. BJU Int 111:249–255. doi:10.1111/j.1464-410X.2012.11322.x CrossRefPubMed

Cheng L, Montironi R, Davidson DD, Lopez-Beltran A (2009) Staging and reporting of urothelial carcinoma of the urinary bladder. Mod Pathol Off J U S Can Acad Pathol Inc 22(Suppl 2):S70–S95. doi:10.1038/modpathol.2009.1

Hafron J, Mitra N, Dalbagni G et al (1995) Physical status: the use and interpretation of anthropometry. Report of a WHO expert committee. World Health Organ Tech Rep Ser 854:1–452

Ehdaie B, Chromecki TF, Lee RK et al (2011) Obesity adversely impacts disease specific outcomes in patients with upper tract urothelial carcinoma. J Urol 186:66–72. doi:10.1016/j.juro.2011.03.031 CrossRefPubMedPubMedCentral

Shariat SF, Karakiewicz PI, Palapattu GS et al (2006) Outcomes of radical cystectomy for transitional cell carcinoma of the bladder: a contemporary series from the Bladder Cancer Research Consortium. J Urol 176:2414–2422. doi:10.1016/j.juro.2006.08.004 (discussion 2422)CrossRefPubMed

Stein JP, Lieskovsky G, Cote R et al (2001) Radical cystectomy in the treatment of invasive bladder cancer: long-term results in 1,054 patients. J Clin Oncol Off J Am Soc Clin Oncol 19:666–675

Hautmann Richard E, de Petriconi Robert C, Pfeiffer Christina, Volkmer Bjoern G (2012) Radical cystectomy for urothelial carcinoma of the bladder without neoadjuvant or adjuvant therapy: long-term results in 1100 patients. Eur Urol 61:1039–1047. doi:10.1016/j.eururo.2012.02.028 CrossRefPubMed

10.

Kluth LA, Rieken M, Xylinas E et al (2014) Gender-specific differences in clinicopathologic outcomes following radical cystectomy: an international multi-institutional study of more than 8000 patients. Eur Urol 66:913–919. doi:10.1016/j.eururo.2013.11.040 CrossRefPubMed

11.

Rink M, Zabor EC, Furberg H et al (2013) Impact of smoking and smoking cessation on outcomes in bladder cancer patients treated with radical cystectomy. Eur Urol 64:456–464. doi:10.1016/j.eururo.2012.11.039 CrossRefPubMed

12.

Rink M, Xylinas E, Babjuk M et al (2012) Impact of smoking on outcomes of patients with a history of recurrent nonmuscle invasive bladder cancer. J Urol 188:2120–2127. doi:10.1016/j.juro.2012.08.029 CrossRefPubMed

13.

Crivelli JJ, Xylinas E, Kluth LA et al (2014) Effect of smoking on outcomes of urothelial carcinoma: a systematic review of the literature. Eur Urol 65:742–754. doi:10.1016/j.eururo.2013.06.010 CrossRefPubMed

14.

Maurer T, Maurer J, Retz M et al (2009) Influence of body mass index on operability, morbidity and disease outcome following radical cystectomy. Urol Int 82:432–439. doi:10.1159/000218533 CrossRefPubMed

15.

Chang SS, Jacobs B, Wells N et al (2004) Increased body mass index predicts increased blood loss during radical cystectomy. J Urol 171:1077–1079. doi:10.1097/01.ju.0000113229.45185.e5 CrossRefPubMed

16.

Lee CT, Dunn RL, Chen BT et al (2004) Impact of body mass index on radical cystectomy. J Urol 172:1281–1285CrossRefPubMed

17.

Iwamura M, Ishibe M, Sluss PM, Cockett AT (1993) Characterization of insulin-like growth factor I binding sites in human bladder cancer cell lines. Urol Res 21:27–32CrossRefPubMed

18.

Suikkari AM, Koivisto VA, Rutanen EM et al (1988) Insulin regulates the serum levels of low molecular weight insulin-like growth factor-binding protein. J Clin Endocrinol Metab 66:266–272. doi:10.1210/jcem-66-2-266 CrossRefPubMed

19.

Hilmy M, Campbell R, Bartlett JMS et al (2006) The relationship between the systemic inflammatory response, tumour proliferative activity, T-lymphocytic infiltration and COX-2 expression and survival in patients with transitional cell carcinoma of the urinary bladder. Br J Cancer 95:1234–1238. doi:10.1038/sj.bjc.6603415 CrossRefPubMedPubMedCentral

20.

Psutka SP, Carrasco A, Schmit GD et al (2014) Sarcopenia in patients with bladder cancer undergoing radical cystectomy: impact on cancer-specific and all-cause mortality. Cancer 120:2910–2918. doi:10.1002/cncr.28798 CrossRefPubMed

21.

Taguchi S, Akamatsu N, Nakagawa T et al (2015) Sarcopenia evaluated using the skeletal muscle index is a significant prognostic factor for metastatic urothelial carcinoma. Clin Genitourin Cancer. doi:10.1016/j.clgc.2015.07.015 PubMed

22.

Batsis JA, Mackenzie TA, Lopez-Jimenez F, Bartels SJ (2015) Sarcopenia, sarcopenic obesity, and functional impairments in older adults: national health and nutrition examination surveys 1999-2004. Nutr Res N Y N 35:1031–1039. doi:10.1016/j.nutres.2015.09.003 CrossRef

Title: Impact of body mass index on the oncological outcomes of patients treated with radical cystectomy for muscle-invasive bladder cancer
Authors: Yohann Dabi
Yohann Rouscoff
Julien Anract
Nicolas Barry Delongchamps
Mathilde Sibony
Djillali Saighi
Marc Zerbib
Michael Peyraumore
Evanguelos Xylinas
Publication date: 01-02-2017
Publisher: Springer Berlin Heidelberg
Published in: World Journal of Urology / Issue 2/2017
Print ISSN: 0724-4983
Electronic ISSN: 1433-8726
DOI: https://doi.org/10.1007/s00345-016-1852-0

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Impact of body mass index on the oncological outcomes of patients treated with radical cystectomy for muscle-invasive bladder cancer

Abstract

Purpose

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 2/2017

Prostate cancer detection rates of magnetic resonance imaging-guided prostate biopsy related to Prostate Imaging Reporting and Data System score

Prognostic value of preoperative NLR, dNLR, PLR and CRP in surgical renal cell carcinoma patients

Antimicrobial prophylaxis for transrectal ultrasound-guided prostate biopsy: fosfomycin trometamol, an attractive alternative

Prospective assessment of perioperative course in 2648 patients after surgical treatment of benign prostatic obstruction

Correlation between prostate volume and single nucleotide polymorphisms implicated in the steroid pathway

Long-term follow-up of intravesical botulinum toxin-A injections in women with idiopathic overactive bladder symptoms