Influence of Body Mass Index on Clinical Outcome Parameters, Complication Rate and Survival after Radical Cystectomy: Evidence from a Prospective European Multicentre Study

Background/Aims/Objectives: To evaluate the influence of body mass index (BMI) on complications and oncological outcomes in patients undergoing radical cystectomy (RC).

Clinical and histopathological parameters of patients have been prospectively collected within the "PROspective MulticEnTer RadIcal Cystectomy Series 2011". BMI was categorized as normal weight (<25 kg/m2), overweight (≥25-29.9 kg/m2) and obesity (≥30 kg/m2). The association between BMI and clinical and histopathological endpoints was examined. Ordinal logistic regression models were applied to assess the influence of BMI on complication rate and survival.

Data of 671 patients were eligible for final analysis. Of these patients, 26% (n = 175) showed obesity. No significant association of obesity on tumour stage, grade, lymph node metastasis, blood loss, type of urinary diversion and 90-day mortality rate was found. According to the -American Society of Anesthesiologists score, local lymph node (NT) stage and operative case load patients with higher BMI had significantly higher probabilities of severe complications 30 days after RC (p = 0.037). The overall survival rate of obese patients was superior to normal weight patients (p = 0.019).

There is no evidence of correlation between obesity and worse oncological outcomes after RC. While obesity should not be a parameter to exclude patients from cystectomy, surgical settings need to be aware of higher short-term complication risks and obese patients should be counselled -accordingly.

Urologia internationalis. 2018 May 02 [Epub ahead of print]

Michael Gierth, Florian Zeman, Stefan Denzinger, Malte W Vetterlein, Margit Fisch, Patrick J Bastian, Isabella Syring, Jörg Ellinger, Stephan C Müller, Edwin Herrmann, Christian Gilfrich, Matthias May, Armin Pycha, Florian M Wagenlehner, Stefan Vallo, Georg Bartsch, Axel Haferkamp, Marc-Oliver Grimm, Jan Roigas, Chris Protzel, Oliver W Hakenberg, Hans-Martin Fritsche, Maximilian Burger, Atiqullah Aziz, Roman Mayr

Department of Urology, University of Regensburg, Regensburg, Germany., Center for Statistics and Clinical Studies, University of Regensburg, Regensburg, Germany., Department of Urology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany., Department of Urology, Marienhospital Düsseldorf, Düsseldorf, Germany., Department of Urology, University Medical Center Bonn, Bonn, Germany., Department of Urology, University Medical Center Münster, Münster, Germany., Department of Urology, St. Elisabeth Medical Center, Straubing, Germany., Department of Urology, Central Hospital Bolzano, Bolzano, Italy., Department of Urology, Pediatric Urology and Andrology, Justus Liebig University of Giessen, Giessen, Germany., Department of Urology, Goethe University Frankfurt, Frankfurt, Germany., Department of Urology, University Medical Center Mainz, Mainz, Germany., Department of Urology, Jena University Hospital, Jena, Germany., Department of Urology, Vivantes Medical Centre Im Friedrichshain and Am Urban, Berlin, Germany., Department of Urology, University Medical Center Rostock, Rostock, Germany.

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