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超重是否会影响肾细胞癌患者的预后?一项针对683例患者的单中心研究经验。

Does overweight impact on the prognosis of patients with renal cell carcinoma? A single center experience of 683 patients.

作者信息

Schips Luigi, Lipsky Katja, Zigeuner Richard, Gidaro Stefano, Salfellner Michael, Rehak Peter, Pummer Karl, Hubmer Gerhart

机构信息

Department of Urology, University Hospital Graz, Karl Franzens University Graz, Austria.

出版信息

J Surg Oncol. 2004 Nov 1;88(2):57-61; discussion 61-2. doi: 10.1002/jso.20139.

Abstract

BACKGROUND AND OBJECTIVES

An increased incidence of renal cell carcinoma (RCC) in obese patients has been reported by several authors. We investigated the association of body mass index (BMI) with prognosis of patients with RCC.

METHODS

From January 1994 to December 2000, 693 operations for RCC in 683 consecutive patients were performed at our institution. Patients' BMI at operation was evaluated, overall, tumor-specific and progression-free survival was investigated using the Kaplan-Meier method, for multivariate analysis the Cox regression model was used.

RESULTS

Four hundred seventeen patients were males, 266 females. Mean age was 62 years (range 16-88). BMI was available in 609 (89.2%). 371/609 (60.9%) of patients exhibited a BMI greater than 25. After a mean follow-up of 41.5 months, 86 (12.6%) patients died from metastatic RCC, and 29 (4.3%) were alive with metastatic disease. A significant advantage regarding overall (P = 0.015) and progression-free (0.017) but not tumor-specific survival (P = 0.057) was found for patients with a BMI of more than 25 compared to normal-weight patients. In multivariate analysis, BMI showed no significant association with tumor-specific survival.

CONCLUSIONS

Patients with a BMI of more than 25 had a better outcome compared to patients with normal weight in univariate analysis but not multivariate analysis.

摘要

背景与目的

多位作者报告肥胖患者肾细胞癌(RCC)的发病率有所增加。我们研究了体重指数(BMI)与RCC患者预后的关系。

方法

1994年1月至2000年12月,我们机构对683例连续患者进行了693例RCC手术。评估患者手术时的BMI,总体上,使用Kaplan-Meier方法研究肿瘤特异性生存率和无进展生存率,多变量分析使用Cox回归模型。

结果

417例为男性,266例为女性。平均年龄为62岁(范围16 - 88岁)。609例(89.2%)患者有BMI数据。609例中的371例(60.9%)患者BMI大于25。平均随访41.5个月后,86例(12.6%)患者死于转移性RCC,29例(4.3%)有转移性疾病存活。与体重正常的患者相比,BMI大于25的患者在总体生存率(P = 0.015)和无进展生存率(0.017)方面有显著优势,但在肿瘤特异性生存率方面无显著优势(P = 0.057)。在多变量分析中,BMI与肿瘤特异性生存率无显著关联。

结论

在单变量分析中,BMI大于25的患者比体重正常的患者预后更好,但在多变量分析中并非如此。

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