体重指数在韩国肾细胞癌患者中的预后价值。

Prognostic value of body mass index in Korean patients with renal cell carcinoma.

机构信息

Department of Urology, Seoul National University Hospital, Seoul, Korea.

出版信息

J Urol. 2010 Feb;183(2):448-54. doi: 10.1016/j.juro.2009.10.004. Epub 2009 Dec 14.

DOI:10.1016/j.juro.2009.10.004

PMID:20006879

Abstract

PURPOSE

Whether body mass index is a prognostic factor in patients with renal cell carcinoma continues to be debated. We investigated the association between body mass index, and clinical/pathological features and prognosis in a large cohort of Korean patients with renal cell carcinoma.

MATERIALS AND METHODS

The medical records of 1,017 patients with renal cell carcinoma who underwent curative surgery between 1988 and 2006 were reviewed. Mean followup was 76.9 months. We analyzed the association of body mass index at surgery with tumor pathological features, and its associations with cancer specific survival and overall survival were evaluated using the Kaplan-Meier method and Cox regression models. Additional survival analysis was performed in a subgroup of 897 patients with T1-4N0M0 disease.

RESULTS

Of the 1,017 patients 363 (35.7%), 526 (51.7%) and 128 (12.6%) had a body mass index of less than 23 (normal), 23 to 27.5 (overweight) and 27.5 or greater (obese) kg/m(2), respectively. Overweight and obese patients had less aggressive tumors, such as less lymph node and/or distant metastases (p = 0.001), low pathological T stage (p = 0.047) and low Fuhrman grade (p = 0.033) vs normal weight patients. In terms of cancer specific survival and overall survival multivariate analysis showed that overweight (p = 0.040 and p = 0.047, respectively) and obese (p = 0.024 and p = 0.010, respectively) patients had good survival rates compared to those with a body mass index in the normal range in the cohort (T1-4NallMall) groups. In addition, overweight (p = 0.022 and p = 0.029, respectively) and obese (p = 0.009 and p = 0.002, respectively) status was significantly associated with cancer specific and overall survival in the T1-4N0M0 groups.

CONCLUSIONS

Our findings suggest that overweight and obese Korean patients with renal cell carcinoma have more favorable pathological features and a better prognosis than those with a normal body mass index.

摘要

目的

体重指数是否是肾细胞癌患者的预后因素仍存在争议。我们研究了在韩国一个大的肾细胞癌患者队列中，体重指数与临床/病理特征和预后之间的关系。

材料和方法

回顾了 1988 年至 2006 年间接受根治性手术的 1017 例肾细胞癌患者的病历。中位随访时间为 76.9 个月。我们分析了手术时体重指数与肿瘤病理特征的关系，并使用 Kaplan-Meier 方法和 Cox 回归模型评估了其与癌症特异性生存和总生存的关系。在 897 例 T1-4N0M0 疾病患者亚组中进行了额外的生存分析。

结果

1017 例患者中，363 例（35.7%）、526 例（51.7%）和 128 例（12.6%）的体重指数分别小于 23（正常）、23 至 27.5（超重）和 27.5 或更高（肥胖）kg/m2。超重和肥胖患者的肿瘤侵袭性较低，如淋巴结和/或远处转移较少（p = 0.001）、病理 T 分期较低（p = 0.047）和 Fuhrman 分级较低（p = 0.033）与体重正常患者相比。在癌症特异性生存和总生存方面，多变量分析显示，超重（p = 0.040 和 p = 0.047，分别）和肥胖（p = 0.024 和 p = 0.010，分别）患者在队列（T1-4NallMall）组中的生存率高于体重指数正常范围的患者。此外，超重（p = 0.022 和 p = 0.029，分别）和肥胖（p = 0.009 和 p = 0.002，分别）状态与 T1-4N0M0 组的癌症特异性和总生存显著相关。