J Urol Oncol.  2023 Mar;21(1):88-94. 10.22465/juo.224400480024.

The Prognostic Significance of Body Mass Index in Patients Undergoing Nephrectomy for Nonmetastatic Renal Cell Carcinoma

• KMID: 2542209
• DOI: http://doi.org/10.22465/juo.224400480024

Abstract

Purpose
The aim of this study was to evaluate the impact of body mass index (BMI) on survival in patients with nonmetastatic renal cell carcinoma (RCC) treated with radical or partial nephrectomy.
Materials and Methods
Between June 1994 and December 2021, 482 patients with RCC underwent radical or partial nephrectomy. Among those patients, 21 patients with lymph node or distant metastasis were excluded. The medical records of the remaining 461 patients were retrospectively reviewed. The prognostic significance of various clinicopathological variables, including BMI, was evaluated in univariate and multivariate analyses.
Results
Of the total 461 patients, 171 (37.1%) were categorized as normal-weight, 118 (25.6%) as overweight, and 172 (37.3%) as obese. Forty-eight patients (10.4%) developed local recurrence or distant metastasis, and 26 patients (5.6%) died from the disease during the follow-up period. In the multivariate analysis, BMI (p=0.017), tumor size (p<0.001), T stage (p<0.001), Fuhrman nuclear grade (p=0.016), and lymphovascular invasion (p=0.012) were independent predictors of recurrence-free survival. Furthermore, BMI (p=0.025), tumor size (p<0.001), T stage (p<0.001), Fuhrman nuclear grade (p=0.047), and lymphovascular invasion (p=0.033) were independent predictors of cancer-specific survival.
Conclusions
Our results suggest that overweight and obese patients with nonmetastatic RCC treated with radical or partial nephrectomy have a more favorable prognosis. These findings indicate that BMI could be an important factor for predicting recurrence or survival in patients undergoing nephrectomy for nonmetastatic RCC.