Lank Center for Genitourinary Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; Harvard Medical School, Boston, MA.
St Bartholomew's Hospital, London, UK; University College London Hospital, London, UK.
Clin Genitourin Cancer. 2019 Aug;17(4):283-290. doi: 10.1016/j.clgc.2019.04.012. Epub 2019 Apr 25.
Obesity at the time of diagnosis has been associated with better outcomes in some metastatic cancers such as renal-cell cancer. The association between body mass index (BMI) and germ-cell tumor (GCT) outcomes has not been reported. We sought to assess the association between BMI and outcomes in men with GCT in a large hospital registry.
Electronic medical records for 1161 GCT patients treated at Dana-Farber Cancer Institute between 1997 and 2012 were reviewed. Information regarding BMI, histology, stage, treatment, and patient characteristics was obtained. We separately evaluated patients with clinical stage 1 and metastatic disease. Using logistic regression analysis, we investigated the association between BMI and clinical features, such as International Germ Cell Consensus Classification (IGCCC) and stage at diagnosis. We used Cox proportional hazards regression to assess the association between BMI and risk of relapse and GCT-specific death.
Among men diagnosed with clinical stage 1 GCT, BMI ≥ 25 kg/m was not associated with an increased risk of relapse (hazard ratio = 0.83; 95% confidence interval, 0.53-1.30) compared to those with BMI < 25 kg/m. In the metastatic disease setting, men with BMI < 25 kg/m were less likely to present with good-risk disease; however, BMI was not associated with risk of relapse (hazard ratio = 1.00; 95% confidence interval, 0.63-1.59, P = .99).
There was no evidence for an association between BMI and GCT outcomes. A lower BMI was associated with adverse prognostic variables at presentation per IGCCC risk groups for metastatic GCT, but this was not associated with relapse.
在某些转移性癌症中，如肾细胞癌，诊断时的肥胖与更好的预后相关。然而，体重指数（BMI）与生殖细胞瘤（GCT）结果之间的关系尚未得到报道。我们试图在一个大型医院登记处评估 BMI 与 GCT 男性患者结局之间的关系。
对 1997 年至 2012 年在 Dana-Farber 癌症研究所接受治疗的 1161 例 GCT 患者的电子病历进行了回顾。获取了关于 BMI、组织学、分期、治疗和患者特征的信息。我们分别评估了临床分期 1 期和转移性疾病患者。使用逻辑回归分析，我们研究了 BMI 与临床特征（如国际生殖细胞共识分类（IGCCC）和诊断时的分期）之间的关系。我们使用 Cox 比例风险回归来评估 BMI 与复发风险和 GCT 特异性死亡之间的关系。
在诊断为临床分期 1 期 GCT 的男性中，与 BMI<25kg/m 的患者相比，BMI≥25kg/m 与复发风险增加无关（风险比=0.83；95%置信区间，0.53-1.30）。在转移性疾病情况下，BMI<25kg/m 的男性更有可能表现为低危疾病；然而，BMI 与复发风险无关（风险比=1.00；95%置信区间，0.63-1.59，P=0.99）。
BMI 与 GCT 结局之间没有关联的证据。根据转移性 GCT 的 IGCCC 风险组，较低的 BMI 与不良预后变量相关，但与复发无关。
