Prognostic Significance of Body Mass Index in Asian Patients With Localized Renal Cell Carcinoma
Prognostic Significance of Body Mass Index in Asian Patients With Localized Renal Cell Carcinoma
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DOI：
10.1080/01635581.2011.594207
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发表时间：
2011-08-01
影响因子：
2.9
通讯作者：
Azuma, Haruhito
中科院分区：
文献类型：
--
作者：
Komura, Kazumasa;Inamoto, Teruo;Azuma, Haruhito
我们研究了亚洲RCC（肾细胞癌）患者BMI（体重指数）的预后价值。我们评估了1996年至2004年在我们机构接受局部RCC（病理T1-4肿瘤，无淋巴结或远处转移）手术的170例亚洲患者。患者按BMI分层：≤ 22 vs.> 22。总体而言，使用Kaplan-Meier方法估计了CSS（癌症特异性生存期）和RFS（无复发生存期）。采用考克斯回归模型进行多因素分析。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。患者人群包括114例（67.1%）男性和56例（32.9%）女性。中位随访时间为50个月。83例（49%）患者的BMI小于22，87例（51%）患者的BMI大于22。有一种趋势，即东部肿瘤协作组（ECOG）的体能状态更差，发生偶发瘤的可能性更小，病理分期更高，BMI越低，微血管浸润越频繁。只有BMI与ECOG体力状态（P = 0.003）和病理分期（P = 0.015）的相关性有统计学意义。其他相关因素包括性别、表现方式、ECOG体力状态、C反应蛋白、组织学类型、Fuhrman核分级、微血管浸润、病理分期和辅助细胞因子治疗，较小的BMI仍然是CSS恶化的独立预测因子（44.5个月vs. 56.0个月，P = 0.041，HR = 10.99）和RFS在多变量分析中，OS（总生存期）（46.0个月vs. 55.5个月，P = 0.13，HR = 2.217）无显著性差异（43.0个月vs. 55.0个月，P = 0.03，HR = 2.653）。我们的研究结果表明，亚洲人群中BMI的增加是手术治疗RCC患者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，以证实这些发现。
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.