Awakura Yasuo, Nakamura Eijiro, Ito Noriyuki, Yamasaki Toshinari, Kamba Tomomi, Kamoto Toshiyuki, Ogawa Osamu
Department of Urology, Kyoto University Graduate School of Medicine, Kyoto, Japan.
Urology. 2007 Jul;70(1):50-4. doi: 10.1016/j.urology.2007.03.034.
Obesity, a significant risk factor for renal cell carcinoma (RCC), has recently become a public health problem in Japan. In addition, the incidence of RCC in Japan has steadily increased during the past few decades. The objective of the present study was to investigate the relationship of body mass index (BMI) to the prognosis of Japanese patients with RCC.
From January 1991 to December 2002, 270 operations for RCC in 269 consecutive Japanese patients were performed at our institution. BMI data were available for 264 (98%) of the 269 patients. Overall, cancer-specific, and recurrence-free survival were investigated using the Kaplan-Meier method, and the Cox regression model was used to determine the significant prognostic factors on multivariate analysis.
Of the 264 patients, 140 (53.0%), 67 (25.4%), and 57 (21.6%) had a BMI of less than 23, 23 to 25, and greater than 25 kg/m2, respectively. These three BMI groups were not significantly different in age, sex, presenting symptoms, tumor stage, or grade. On univariate analysis, a significant advantage regarding overall and cancer-specific, but not recurrence-free, survival was found for patients with a BMI of 23 kg/m2 or greater compared with those with a BMI of less than 23 kg/m2. Also, on multivariate analysis, the BMI was significantly associated with overall and cancer-specific, but not recurrence-free, survival.
Our findings suggest that a BMI of 23 kg/m2 or more favorably affects the prognosis of Japanese patients with RCC. However, additional studies are needed to verify these results.
肥胖是肾细胞癌(RCC)的一个重要危险因素,近年来在日本已成为一个公共卫生问题。此外,在过去几十年中,日本RCC的发病率一直在稳步上升。本研究的目的是调查体重指数(BMI)与日本RCC患者预后的关系。
1991年1月至2002年12月,我们机构对269例连续的日本患者进行了270例RCC手术。269例患者中有264例(98%)可获得BMI数据。采用Kaplan-Meier法研究总生存率、癌症特异性生存率和无复发生存率,并使用Cox回归模型在多变量分析中确定显著的预后因素。
264例患者中,BMI小于23、23至25、大于25kg/m²的患者分别有140例(53.0%)、67例(25.4%)和57例(21.6%)。这三个BMI组在年龄、性别、症状、肿瘤分期或分级方面无显著差异。单变量分析发现,与BMI小于23kg/m²的患者相比,BMI为23kg/m²或更高的患者在总生存率和癌症特异性生存率方面有显著优势,但在无复发生存率方面没有。此外,多变量分析显示,BMI与总生存率和癌症特异性生存率显著相关,但与无复发生存率无关。
我们的研究结果表明,BMI为23kg/m²或更高对日本RCC患者的预后有有利影响。然而,需要进一步的研究来验证这些结果。