Jeong Hyun Cheol, Bashraheel Fahad K, Byun Seok-Soo, Kwak Cheol, Hwang Eu Chang, Kang Seok Ho, Chung Jinsoo, Kim Tae-Hwan, Kim Yong-June, Hong Sung-Hoo
Department of Urology, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea.
Department of Urology, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Asia Pac J Clin Oncol. 2019 Apr;15(2):e36-e42. doi: 10.1111/ajco.13073. Epub 2018 Oct 10.
Recently, there have been some reports on preoperative body mass index (BMI) and total cholesterol (TC) as a prognostic predictor for patients with renal cell carcinoma (RCC) but the topic is controversial and still poorly understood. So we analyzed the effects of BMI and TC on the prognosis of RCC.
Retrospective data from 1988 to 2015 were collected from eight centers with a total of 7,271 patients surgically treated for nonmetastatic RCC. Receiver operating characteristic curve analysis was analyzed and the highest Youden index was shown at 163.5 mg/dL. According to the Asian BMI criteria, patients were divided into normal BMI < 25 kg/m and high BMI ≥ 25 kg/m . Kaplan-Meier analysis, multivariate Cox regression model were performed to identify the overall survival (OS) and the recurrence-free survival (RFS).
Normal BMI and low TC group was associated with the shortest OS and RFS as compared to the other groups significantly. In the male patients, the results showed similar to the whole sample. But in the female, BMI had no effect on both OS and RFS. On multivariate Cox regression analysis, low TC was an independent predictor for OS in both genders. However, normal BMI was a significant prognostic factor in the males only.
Preoperative BMI and TC are good predictive factors for both OS and RFS significantly in RCC patients. Also, TC was an independent predictor for OS in all RCC patients; however, BMI was a significant predictor in males only.
最近,有一些关于术前体重指数(BMI)和总胆固醇(TC)作为肾细胞癌(RCC)患者预后预测指标的报道,但该话题存在争议且仍未得到充分理解。因此,我们分析了BMI和TC对RCC预后的影响。
收集了1988年至2015年来自八个中心的回顾性数据,共有7271例接受非转移性RCC手术治疗的患者。进行了受试者工作特征曲线分析,最高约登指数显示为163.5mg/dL。根据亚洲BMI标准,患者被分为正常BMI<25kg/m²和高BMI≥25kg/m²。采用Kaplan-Meier分析和多变量Cox回归模型来确定总生存期(OS)和无复发生存期(RFS)。
与其他组相比,正常BMI和低TC组的OS和RFS明显最短。在男性患者中,结果与整个样本相似。但在女性中,BMI对OS和RFS均无影响。多变量Cox回归分析显示,低TC是两性OS的独立预测因素。然而,正常BMI仅是男性的显著预后因素。
术前BMI和TC对RCC患者的OS和RFS均是显著的良好预测因素。此外,TC是所有RCC患者OS的独立预测因素;然而,BMI仅是男性的显著预测因素。