Body Mass Index and Survival in a Prospective Randomized Trial of Localized High Risk Renal Cell Carcinoma.

BACKGROUND The relationship between adiposity and renal cell carcinoma is poorly understood. Prior studies have suggested BMI (body mass index) may be associated with indolent disease. METHODS We reviewed the clinicopathologic records of 845 patients across 14 countries who were enrolled in a prospective, placebo-controlled study of adjuvant Girentuximab treatment for high-risk renal cell carcinoma.

Clinical features analyzed included age, gender, race, BMI, and performance status. BMI was stratified into <25 kg/m2, 25.0-29.9 kg/m2, 30.0-34.9 kg/m2, and {greater than or equal to}35 kg/m2. We examined the association of BMI with stage and survival using logistic and Cox regression analyses, respectively. RESULTS 845 patients were included for analysis. The majority (72%) were overweight/obese. There was an inverse relationship between BMI and lymph node involvement (p=0.04). Obesity was associated with improved disease-free and overall survival (log rank <0.01 for both). When compared with normal weight subjects, those with a BMI 30-34.9 (HR 0.50, 95% CI 0.31-0.81) and BMI {greater than or equal to}35 (HR 0.24, 95% CI 0.09-0.60) had significantly improved overall survival. A trend towards improved disease-free survival was found among subjects with BMI 30-34.9 (HR 0.77, 95% CI 0.56-1.05) and {greater than or equal to}35 (HR 0.74, 95% CI 0.48-1.15). CONCLUSIONS In a prospective cohort of nephrectomized patients with high-risk disease, obesity is associated with lower risk of lymphatic spread and improved overall survival. IMPACT This is the first study utilizing data from a prospective randomized trial reporting an association between obesity and improved overall survival for patients with clear cell renal cell carcinoma.

Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology. 2016 Jul 14 [Epub ahead of print]

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Nicholas M Donin, Allan Pantuck, Pia Klöpfer, Paul Bevan, Barbara Fall, Jonathan Said, Arie S Belldegrun, Karim Chamie

Urology, David Geffen School of Medicine at UCLA., Urology, UCLA School of Medicine., Wilex, AG., Research, Wilex., Research, Wilex., Department of Pathology and Laboratory Medicine, University of California Los Angeles., Urology, UCLA., Urology, UCLA .