MP47-14 THE IMPACT OF BODY MASS INDEX (BMI) ON ONCOLOGICAL AND SURGICAL OUTCOMES OF PATIENTS UNDERGOING NEPHRECTOMY: A SYSTEMATIC REVIEW AND META-ANALYSIS

Abstract

You have accessJournal of UrologyCME1 Apr 2023MP47-14 THE IMPACT OF BODY MASS INDEX (BMI) ON ONCOLOGICAL AND SURGICAL OUTCOMES OF PATIENTS UNDERGOING NEPHRECTOMY: A SYSTEMATIC REVIEW AND META-ANALYSIS Chloe Ong, Terence Law, Alex Mok, Kenny Ho, Ziting Wang, Edmund Chiong, Ho Yee Tiong, and Jeremy Teoh Chloe OngChloe Ong More articles by this author , Terence LawTerence Law More articles by this author , Alex MokAlex Mok More articles by this author , Kenny HoKenny Ho More articles by this author , Ziting WangZiting Wang More articles by this author , Edmund ChiongEdmund Chiong More articles by this author , Ho Yee TiongHo Yee Tiong More articles by this author , and Jeremy TeohJeremy Teoh More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003293.14AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Obesity, or high body mass index (BMI), is a known risk factor for renal cell carcinoma and predictor of poorer outcomes in general. Our aim is to perform a systematic review and meta-analysis to evaluate the impact of BMI on oncological (primary) and surgical (secondary) outcomes of patients who underwent nephrectomy. METHODS: The review protocol was registered in PROSPERO with ID CRD42021275124. Studies were identified from four electronic databases. Two independent authors conducted the screening and data extraction, while a third resolved discrepancies. Studies which addressed post-nephrectomy oncological and surgical outcomes were included. RESULTS: Twenty-three studies consisting 18,546 patients were identified for the final meta-analysis. Regarding oncological outcomes, higher BMI was shown to predict higher overall survival (BMI >25 versus BMI < 25: HR 0.70, 95% CI 0.58—0.85, p<0.001; BMI 25-30 versus BMI < 25: HR 0.84, 95% CI 0.73—0.96, p=0.01), cancer-specific survival (BMI >25 versus BMI < 25: HR 0.58, 95% CI 0.49—0.69, p<0.001; BMI 25-30 versus BMI <25: HR 0.73, 95% CI 0.63—0.85, p<0.001; BMI > 30 versus BMI < 25: HR 0.58, 95% CI 0.49—0.70, p<0.001) and recurrence-free survival rates (BMI >25 versus BMI < 25: HR 0.72, 95% CI 0.63—0.82, p<0.001; BMI 25-30 versus BMI < 25: HR 0.55, 95% CI 0.42—0.73, p<0.001). Lower BMI fared better in surgical outcomes such as operation time and warm ischaemic time, although the absolute difference was minimal and unlikely to be clinically significant. There was no difference between groups for length of hospital stay, intra-operative or post-operative complications, blood transfusion requirements, and conversion to open. CONCLUSIONS: Our study suggests that higher BMI is associated with improved long-term oncological survival and similar perioperative outcomes as lower BMI. More research into the underlying biological and physiological mechanisms will enable better understanding of the effect of BMI, beyond mere association, on post-nephrectomy outcomes. Source of Funding: NA © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e649 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Chloe Ong More articles by this author Terence Law More articles by this author Alex Mok More articles by this author Kenny Ho More articles by this author Ziting Wang More articles by this author Edmund Chiong More articles by this author Ho Yee Tiong More articles by this author Jeremy Teoh More articles by this author Expand All Advertisement PDF downloadLoading ...