Department of Urology, Osaka Medical College, Takatsuki City, Osaka, Japan.
Nutr Cancer. 2011;63(6):908-15. doi: 10.1080/01635581.2011.594207. Epub 2011 Jul 29.
We investigated the prognostic value of BMI (body mass index) in Asian patients with RCC (renal cell carcinoma). We evaluated 170 Asian patients who underwent surgery for localized RCC (pathologic T1-4 tumors in the absence of nodal or distant metastases) between 1996 and 2004 at our institution. Patients were stratified by BMI: 22 or less vs. greater than 22. Overall, CSS (cancer-specific survival) and RFS (recurrence-free survival) was estimated using the Kaplan-Meier method. Multivariate analysis was performed with the Cox regression model. The mean age and BMI of all patients was 62.4 ± 11.4 yr and 23.1 ± 3.2 kg/m(2), respectively. Patients' population consisted of 114 (67.1%) men and 56 (32.9%) women. The median follow-up was 50 mo. The BMI was less than 22 in 83 (49%) patients and greater than 22 in 87 (51%). There was a trend toward worse Eastern Cooperative Oncology Group (ECOG) performance status, less likely to have an incidentaloma, higher pathological stage, and more frequent microvascular invasion with lower BMI. Only the correlations between BMI and ECOG performance status (P = 0.003) and pathological stage (P = 0.015) were statistically significant. Of other relevant factors including gender, mode of presentation, ECOG performance status, C-reactive protein, histological type, Fuhrman nuclear grade, microvascular invasion, pathological stage, and adjuvant cytokine therapy, smaller BMI remained an independent predictor for worse CSS (44.5 mo vs. 56.0 mo, P = 0.041, HR = 10.99) and RFS (43.0 mo vs. 55.0 mo, P = 0.03, HR = 2.653), but not for OS (overall survival) (46.0 mo vs. 55.5 mo, P = 0.13, HR = 2.217) on multivariate analysis. Our findings identify increasing BMI in the Asian population as an independent predictor for favorable CSS and RFS in patients with RCC treated by surgery. Further studies, including a multiinstitutional, prospective Asian cohort, are required to confirm these findings.
我们研究了 BMI（体重指数）在亚洲肾细胞癌患者中的预后价值。我们评估了 1996 年至 2004 年期间在我院接受手术治疗局限性肾细胞癌（无淋巴结或远处转移的病理 T1-4 期肿瘤）的 170 名亚洲患者。患者按 BMI 分层：22 或以下与大于 22。总体而言，使用 Kaplan-Meier 方法估计 CSS（癌症特异性生存）和 RFS（无复发生存）。使用 Cox 回归模型进行多变量分析。所有患者的平均年龄和 BMI 分别为 62.4 ± 11.4 岁和 23.1 ± 3.2 kg/m²。患者人群由 114 名（67.1%）男性和 56 名（32.9%）女性组成。中位随访时间为 50 个月。BMI 小于 22 的患者 83 例（49%），大于 22 的患者 87 例（51%）。ECOG 表现状态较差、偶然发现肿瘤的可能性较低、病理分期较高、微血管侵犯更频繁的趋势与较低的 BMI 相关。只有 BMI 与 ECOG 表现状态（P = 0.003）和病理分期（P = 0.015）之间的相关性具有统计学意义。其他相关因素包括性别、表现方式、ECOG 表现状态、C 反应蛋白、组织学类型、Fuhrman 核分级、微血管侵犯、病理分期和辅助细胞因子治疗，较小的 BMI 仍然是 CSS（44.5 个月 vs. 56.0 个月，P = 0.041，HR = 10.99）和 RFS（43.0 个月 vs. 55.0 个月，P = 0.03，HR = 2.653）较差的独立预测因素，但对 OS（总体生存）（46.0 个月 vs. 55.5 个月，P = 0.13，HR = 2.217）没有影响。我们的研究结果表明，在接受手术治疗的肾细胞癌患者中，亚洲人群 BMI 的增加是 CSS 和 RFS 良好的独立预测因素。需要进一步的研究，包括多机构、前瞻性亚洲队列研究，以证实这些发现。
