MP47-11 DIFFERENTIAL ASSOCIATION OF BODY MASS INDEX ON SURVIVAL OUTCOMES IN RENAL CELL CARCINOMA: IMPACT OF TUMOR HISTOLOGY

Abstract

You have accessJournal of UrologyCME1 May 2022MP47-11 DIFFERENTIAL ASSOCIATION OF BODY MASS INDEX ON SURVIVAL OUTCOMES IN RENAL CELL CARCINOMA: IMPACT OF TUMOR HISTOLOGY Arman Walia, Yasuhisa Fujii, Viraj Master, Ava Saidian, Rekha Narasimhan, Mimi Nguyen, John Perry, Margaret Meagher, Madison Chakoumakos, Kevin Hakimi, Dattatraya Patil, Yosuke Yasuda, Hajime Tanaka, and Ithaar Derweesh Arman WaliaArman Walia More articles by this author , Yasuhisa FujiiYasuhisa Fujii More articles by this author , Viraj MasterViraj Master More articles by this author , Ava SaidianAva Saidian More articles by this author , Rekha NarasimhanRekha Narasimhan More articles by this author , Mimi NguyenMimi Nguyen More articles by this author , John PerryJohn Perry More articles by this author , Margaret MeagherMargaret Meagher More articles by this author , Madison ChakoumakosMadison Chakoumakos More articles by this author , Kevin HakimiKevin Hakimi More articles by this author , Dattatraya PatilDattatraya Patil More articles by this author , Yosuke YasudaYosuke Yasuda More articles by this author , Hajime TanakaHajime Tanaka More articles by this author , and Ithaar DerweeshIthaar Derweesh More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002618.11AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The “obesity paradox” for renal cell carcinoma (RCC) has been described in clear cell histology. We investigated impact of Body Mass Index (BMI) on outcomes in Clear Cell (ccRCC) and Non-Clear Cell RCC (nccRCC). METHODS: The International Marker Consortium for Renal Cancer database was retrospectively analyzed for patients with ccRCC and nccRCC (papillary and chromophobe). Adult BMI (kg/m2) cutoffs were defined as obese >30 and non-obese ≤30. Descriptive analyses were conducted for demographics and disease characteristics. Multivariate analysis (MVA) via Cox regression and Kaplan Meier analyses (KMA) were conducted for survival assessment. Primary outcome was risk of cancer-specific mortality (CSM); secondary outcome was all-cause mortality (ACM). RESULTS: 3,742 patients were included (ccRCC n=2,895/nccRCC n=847; median follow up 107 months). BMI >30 was independently associated with lower risk of CSM in ccRCC patients (HR 0.69, p=0.038). Hypertension (HR 2.29, p <0.001), high grade (HR 3.27, p <0.001), and stage 3/4 (HR 5.29, p <0.001) were associated with increased risk of CSM. For nccRCC, stage 3/4 disease (HR 19.48, p <0.001) was associated with worsened CSM, while BMI >30 was not a risk factor (HR 1.38, p=0.415).BMI >30 was independently associated with decreased ACM in ccRCC patients (HR 0.74, p=0.011). Age (HR 1.03, p <0.001), male gender (HR 1.39, p <0.001), hypertension (HR 1.39, p<0.001), high grade (HR 1.72, p <0.001), and stage 3/4 (HR 2.33, p <0.001) were associated with increased risk of ACM, while increasing preoperative eGFR (HR 0.99, p <0.001) was protective. BMI >30 was not a risk factor for ACM in nccRCC (HR 0.99, p=0.99). Figure 1 provides KMA survival curves for cancer-specific (CSS) and overall survival (OS). For ccRCC stratified by BMI >30 and ≤30, 5-year CSS rates were 88% vs 88% (p=0.686) and OS 77% vs 73% (p=0.022), respectively. For nccRCC, 5-year CSS rates were 91% vs 93% (p=0.620) and OS 78% vs 80% (p=0.180) for BMI >30 and ≤30, respectively. CONCLUSIONS: BMI >30 was independently associated with decreased risk of mortality outcomes in ccRCC but not nccRCC. Mechanisms are unclear but call for further investigation into impact of BMI and metabolic sequelae on different RCC histologic subtypes. Source of Funding: None © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e814 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Arman Walia More articles by this author Yasuhisa Fujii More articles by this author Viraj Master More articles by this author Ava Saidian More articles by this author Rekha Narasimhan More articles by this author Mimi Nguyen More articles by this author John Perry More articles by this author Margaret Meagher More articles by this author Madison Chakoumakos More articles by this author Kevin Hakimi More articles by this author Dattatraya Patil More articles by this author Yosuke Yasuda More articles by this author Hajime Tanaka More articles by this author Ithaar Derweesh More articles by this author Expand All Advertisement PDF DownloadLoading ...