scholarly journals Impact of obesity on the evolution of outcomes in peritoneal dialysis patients

2020 ◽  
Author(s):  
Maria Quero ◽  
Jordi Comas ◽  
Emma Arcos ◽  
Miguel Hueso ◽  
Diego Sandoval ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Univariate Analysis ◽  
Normal Weight ◽  
Hazard Ratio ◽  
Obese Patients ◽  
Weight Changes ◽  
Technique Survival ◽  
Undergo Kidney Transplantation ◽  
Using Data ◽  
The Impact

Abstract Background Some studies reveal that obesity is associated with a decrease in mortality in haemodialysis (HD) patients. However, few studies have addressed the association between body mass index (BMI) and peritoneal dialysis (PD) patients. Methods We performed this longitudinal, retrospective study to evaluate the impact of obesity on PD patients, using data from the Catalan Registry of Renal Patients from 2002 to 2015 (n = 1573). Obesity was defined as BMI ≥30; low weight: BMI <18.5; normal range: BMI = 18.5–24.99; and pre-obesity: BMI = 25–29.99 kg/m2. Variations in BMI were calculated during follow-up. The main outcomes evaluated were the technique and patient survival. Results Obesity was observed in 20% of patients starting PD. We did not find differences in sex or PD modality, with the obesity group being older (65.9% are ≥55 years versus 59% non-obese, P = 0.003) and presenting more diabetes mellitus and cardiovascular disease (CVD) (47.9% obese versus 25.1% non-obese and 41.7% versus 31.5%, respectively). We did not observe differences in haemoglobin, albumin and Kt/V in obese patients. Regarding peritonitis rate, we did not find any difference between groups, presenting more peritonitis patients on continuous ambulatory peritoneal dialysis and aged ≥65 years [sub-hazard ratio (SHR) = 1.75, P = 0.000 and SHR = 1.56, P = 0.009]. In relation to technique survival, we found higher transfer to HD in the obese group of patients in the univariate analysis, which was not confirmed in the multivariate analysis (SHR = 1.12, P = 0.4), and we did not find differences in mortality rate. In relation to being transplanted, the underweight group, elderly and patients with CVD or diabetic nephropathy presented less probability to undergo kidney transplantation (SHR = 0.65, 0.24, 0.5 and 0.54, P < 0.05). Obese patients did not present differences in survival with weight changes but in normal-weight patients, a gain of 7% of the basal weight during the first year had a protective effect on death risk (hazard ratio 0.6, P = 0.034). Conclusions Obese and non-obese patients starting on PD had similar outcomes.

Efficacy of Calcipotriol-Betamethasone Ointment in Patients with Mild to Moderate Plaque Psoriasis: Subgroup Analyses

Dermatology ◽  
2019 ◽  
Vol 235 (6) ◽  
pp. 501-508 ◽  
Author(s):  
Nina Habjanič ◽  
Vesna Lužar-Stiffler ◽  
Mojca Kerec-Kos ◽  
Darja Grabnar Peklar
Keyword(s):  
Plaque Psoriasis ◽  
Treatment Effectiveness ◽  
Late Onset ◽  
Univariate Analysis ◽  
Severity Index ◽  
Normal Weight ◽  
Response To Treatment ◽  
Using Data ◽  
The Impact ◽  
Calcipotriol Betamethasone

Background: Several factors have been shown to affect psoriasis pathogenesis, clinical presentation and treatment response. Objectives: The aim of this study was to investigate the potential relationship between patients’ baseline characteristics and the efficacy of calcipotriol-betamethasone ointment in patients with mild to moderate plaque psoriasis and to evaluate whether the efficacy is consistent across subgroups. Method: Using data from the therapeutic equivalence study on patients with plaque psoriasis, post hoc analyses were performed to evaluate the impact of baseline demographic and disease characteristics, habits and comorbidities on the response to treatment with calcipotriol-betamethasone ointment. Results: Body mass index (BMI) and obesity were each independently associated (univariate analysis, p < 0.05) with reduction in modified Psoriasis Area and Severity Index (mPASI) and PASI75 (≥75% improvement in mPASI from baseline). Increased body weight is more common in patients with late-onset psoriasis. There was a significant trend for lower response rates with increasing BMI (p = 0.007) and obesity (p = 0.003). The odds of achieving PASI75 is 2.3 times lower for obese compared to normal-weight subjects.If patients with obesity or hypertension were treated with calcipotriol-betamethasone, they were still more likely to achieve PASI75 after 4-week treatment compared to vehicle (p < 0.001). Conclusion: Increased BMI and obesity present risk factors for reduced treatment effectiveness. Importantly, the efficacy of calcipotriol-betamethasone ointment was consistent in all subgroups.

scholarly journals Effect of Body Mass Index on Outcomes of Peritoneal Dialysis Patients in India

2014 ◽  
Vol 34 (4) ◽  
pp. 399-408 ◽  
Author(s):  
Narayan Prasad ◽  
Archana Sinha ◽  
Amit Gupta ◽  
Raj Kumar Sharma ◽  
Dharmendra Bhadauria ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Peritoneal Dialysis ◽  
Body Mass ◽  
Patient Survival ◽  
Normal Weight ◽  
Obese Patients ◽  
Reference Category ◽  
Technique Survival ◽  
Patients With Diabetes ◽  
Underweight Patients

ObjectivesWe studied the effect of body mass index (BMI) at peritoneal dialysis (PD) initiation on patient and technique survival and on peritonitis during follow-up.MethodsWe followed 328 incident patients on PD (176 with diabetes; 242 men; mean age: 52.6 ± 12.6 years; mean BMI: 21.9 ± 3.8 kg/m2) for 20.0 ± 14.3 months. Patients were categorized into four BMI groups: obese, ≥25 kg/m2; overweight, 23 – 24.9 kg/m2; normal, 18.5 – 22.9 kg/m2(reference category); and underweight, <18.5 kg/m2. The outcomes of interest were compared between the groups.ResultsOf the 328 patients, 47 (14.3%) were underweight, 171 (52.1%) were normal weight, 53 (16.2%) were overweight, and 57 (17.4%) were obese at commencement of PD therapy. The crude hazard ratio (HR) for mortality ( p = 0.004) and the HR adjusted for age, subjective global assessment, comorbidities, albumin, diabetes, and residual glomerular filtration rate ( p = 0.02) were both significantly greater in the underweight group than in the normal-weight group. In comparison with the reference category, the HR for mortality was significantly greater for underweight PD patients with diabetes [2.7; 95% confidence interval (CI): 1.5 to 5.0; p = 0.002], but similar for all BMI categories of nondiabetic PD patients. Median patient survival was statistically inferior in underweight patients than in patients having a normal BMI. Median patient survival in underweight, normal, overweight, and obese patients was, respectively, 26 patient–months (95% CI: 20.9 to 31.0 patient–months), 50 patient–months (95% CI: 33.6 to 66.4 patient–months), 57.7 patient–months (95% CI: 33.2 to 82.2 patient–months), and 49 patient–months (95% CI: 18.4 to 79.6 patient–months; p = 0.015). Death-censored technique survival was statistically similar in all BMI categories. In comparison with the reference category, the odds ratio for peritonitis occurrence was 1.8 (95% CI: 0.9 to 3.4; p = 0.086) for underweight patients; 1.7 (95% CI: 0.9 to 3.2; p = 0.091) for overweight patients; and 3.4 (95% CI: 1.8 to 6.4; p < 0.001) for obese patients.ConclusionsIn our PD patients, mean BMI was within the normal range. The HR for mortality was significantly greater for underweight diabetic PD patients than for patients in the reference category. Death-censored technique survival was similar in all BMI categories. Obese patients had a greater risk of peritonitis.

scholarly journals Body weight and return to work among survivors of early-stage breast cancer

ESMO Open ◽  
2020 ◽  
Vol 5 (6) ◽  
pp. e000908
Author(s):  
Antonio Di Meglio ◽  
Gwenn Menvielle ◽  
Agnes Dumas ◽  
Arnauld Gbenou ◽  
Sandrine Pinto ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Weight Loss ◽  
Body Weight ◽  
Weight Gain ◽  
Return To Work ◽  
Normal Weight ◽  
Psychosocial Treatment ◽  
Obese Patients ◽  
Weight Changes ◽  
The Impact

BackgroundMany breast cancer (BC) survivors are employed at diagnosis and are expected to return to work after treatment. Among them, around 50% are overweight or obese. There are limited data about the impact of body weight on their ability to return to work.MethodsWe used data from CANcer TOxicity (NCT01993498), a prospective, multicentre cohort of women with stage I–III BC. Professionally active women who were ≥5 years younger than retirement age were identified. Multivariable logistic regression models examined associations of body mass index (BMI) at diagnosis and subsequent weight changes with non-return to work 2 years after diagnosis, adjusting for psychosocial, treatment and behavioural characteristics.ResultsAmong 1869 women, 689 were overweight or obese. Overall, 398 patients (21.3%) had not returned to work 2 years after diagnosis. Non-return to work was more likely for overweight or obese than underweight or normal weight patients (adjusted OR (aOR) 1.32; 95% CI, 1.01 to 1.75; p=0.045). Weight loss (≥5%) was observed in 15.7% overweight or obese and 8.7% underweight or normal weight patients and was associated with significant increases in physical activity only among overweight or obese patients (mean change, +4.7 metabolic-equivalent-of-task-hour/week; 95% CI +1.9 to +7.5). Overweight or obese patients who lost weight were more likely to return to work compared with those who did not lose weight (aOR of non-return-to-work, 0.48; 95% CI 0.24 to 0.97, p=0.0418), whereas weight loss was associated with increased odds of non-return to work among underweight or normal weight women (aOR 2.07; 95% CI 1.20 to 3.56, p=0.0086) (pinteractionBMI×weight changes=0.0002). The continuous trend of weight gain on non-return to work was significant for overweight or obese patients (aOR for one-percent-unit difference, 1.03; 95% CI 1.01 to 1.06, p=0.030).ConclusionsExcess weight may be a barrier to return to work. Among overweight or obese BC survivors, weight loss was associated with higher rates of return to work, whereas further weight gain was associated with lower likelihood of return to work. Employment outcomes should be evaluated in randomised studies of weight management.

MO698IS PERITONEAL DIALYSIS SUITABLE METHOD FOR OBESE PATIENTS?

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Tatjana Damjanovic ◽  
Jelena Bjedov ◽  
Vesna Maslarevic Radovic ◽  
Bojan Stopić ◽  
Tatjana Rajcic ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Statistical Significance ◽  
Normal Weight ◽  
Prospective Clinical Study ◽  
Obese Patients ◽  
Adequate Treatment ◽  
Technique Survival ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Abstract Background and Aims In recent years, obesity has reached epidemic proportions, and it's a great challenge to choose an adequate treatment for obese ESRD patients. The aim of the study was to analyze the outcome in patients with peritoneal dialysis with different degrees of nutrition expressed through body mass index at the beginning of treatment. Method The prospective clinical study included 53 incidental patients, who started peritoneal dialysis between June 2006 and August 2015. According to BMI on the beginning of treatment, patients were divided into three groups: normal weight: BMI of 18.5 - 24.9 kg/m2, n=17, overweight: BMI of 25 - 29.9 kg/m2, n=25, obese: BMI&gt; 30.0 kg/m2. n=11. Mechanical and infective complications, technique survival and patients survival were analyzed over 48 - months period. Results In terms of mechanical complications, there was no difference between the groups- malposition of the catheter (p = 0.769), leakage of dialysate (p = 0.462), hernia (p = 0.381). Exit sitе infection were most prevalent in group 3 - 1 episode/22 patient months vs 1 episode/30 patient months in groups 1 and 2, but without statistical significance (p = 0.272). However, the lowest incidence of peritonitis was in the group 3 - 1 episode/40 patient months vs 1 episode/30 patient months in group 2, and 1 episode/33 patient months in group 1, but even here the difference did not reach statistical significance (p = 0.624). Cardiovascular events – myocardial infarction, stroke and peripheral vascular disease were rare in all groups, with no statistical significance between groups. The incidence of hospitalizations was highest in the obese group – 1 episode/22 patient months vs 1 episode/27 patient months in group 2, and 1 episode/25 patient months in group 1 (p = 0.735). Kaplan Meier's analysis showed the worst, but not significant, survival of the technique in a group of obese patients (group 1 vs. group 2; p = 0.536; group 1 vs. group 3 - p= 0.662; group 2 vs. group 3 - p = 0.357). Also, overall patient survival was not differed between the groups (group 1 vs group 2 - p = 0.387; group 1 vs group 3 - p= 0.885; group 2 vs group 3 - p = 0.375). According to Cox's analysis, only values of total cholesterol at the end of the follow-up period (p = 0.027) and diastolic blood pressure (p = 0.013) were significantly associated with overall survival obese patients. Conclusion In the present study the degree of nutrition at the beginning of treatment had no significant effect on the outcome of peritoneal dialysis treatment. Therefore, patients should not be discouraged for peritoneal dialysis on the basis of BMI.

scholarly journals Higher body mass index is associated with larger postoperative improvement in patient-reported outcomes following total knee arthroplasty

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
K Giesinger ◽  
JM Giesinger ◽  
DF Hamilton ◽  
J Rechsteiner ◽  
A Ladurner
Keyword(s):  
Body Mass Index ◽  
Total Knee Arthroplasty ◽  
Pain Relief ◽  
Body Mass ◽  
Knee Arthroplasty ◽  
Normal Weight ◽  
World Health ◽  
Obese Patients ◽  
Total Knee ◽  
The Impact

Abstract Background Total knee arthroplasty is known to successfully alleviate pain and improve function in endstage knee osteoarthritis. However, there is some controversy with regard to the influence of obesity on clinical benefits after TKA. The aim of this study was to investigate the impact of body mass index (BMI) on improvement in pain, function and general health status following total knee arthroplasty (TKA). Methods A single-centre retrospective analysis of primary TKAs performed between 2006 and 2016 was performed. Data were collected preoperatively and 12-month postoperatively using WOMAC score and EQ-5D. Longitudinal score change was compared across the BMI categories identified by the World Health Organization. Results Data from 1565 patients [mean age 69.1, 62.2% women] were accessed. Weight distribution was: 21.2% BMI < 25.0 kg/m2, 36.9% BMI 25.0–29.9 kg/m2, 27.0% BMI 30.0–34.9 kg/m2, 10.2% BMI 35.0–39.9 kg/m2, and 4.6% BMI ≥ 40.0 kg/m2. All outcome measures improved between preoperative and 12-month follow-up (p < 0.001). In pairwise comparisons against normal weight patients, patients with class I-II obesity showed larger improvement on the WOMAC function and total score. For WOMAC pain improvements were larger for all three obesity classes. Conclusions Post-operative improvement in joint-specific outcomes was larger in obese patients compared to normal weight patients. These findings suggest that obese patients may have the greatest benefits from TKA with regard to function and pain relief one year post-op. Well balanced treatment decisions should fully account for both: Higher benefits in terms of pain relief and function as well as increased potential risks and complications. Trial registration This trial has been registered with the ethics committee of Eastern Switzerland (EKOS; Project-ID: EKOS 2020–00,879)

scholarly journals Insulin Resistance as a Predictor of Cardiovascular Disease in Patients on peritoneal dialysis

2013 ◽  
Vol 33 (4) ◽  
pp. 411-418 ◽  
Author(s):  
Yun Li ◽  
Lihua Zhang ◽  
Yong Gu ◽  
Chuanming Hao ◽  
Tongying Zhu
Keyword(s):  
Insulin Resistance ◽  
Peritoneal Dialysis ◽  
Independent Predictor ◽  
Hazard Ratio ◽  
Diabetic Patients ◽  
Model Assessment ◽  
Mortality Hazard ◽  
Cv Disease ◽  
The Impact ◽  
Mortality Hazard Ratio

BackgroundInsulin resistance is associated with multiple risk factors for cardiovascular (CV) disease in the general population. Patients on peritoneal dialysis (PD) are more likely to develop insulin resistance. However, no evaluation of the impact of insulin resistance on CV disease morbidity or mortality in patients on PD has been performed.MethodsOur prospective cohort study included all non-diabetic patients on PD at our center ( n = 66). Insulin resistance was evaluated at baseline by the homeostasis model assessment method (HOMA-IR) using fasting glucose and insulin levels. The cohort was followed for up to 58 months (median: 41.3 months; interquartile range: 34.3 months). A multivariate Cox model was used to analyze the impact of insulin resistance on CV disease mortality.ResultsFourteen CV events occurred in the higher HOMA-IR group [IR-H (HOMA-IR values in the range 2.85 – 19.5), n = 33], but only one event occurred in the lower HOMA-IR group (IR-L (HOMA-IR values in the range 0.83 – 2.71), n = 33) during the follow-up period. Level of HOMA-IR was a significant predictor of CV events [risk ratio: 17.7; 95% confidence interval (CI): 2.10 to 149.5; p = 0.008]. In the IR-H group, 10 patients died (8 CV events), but in the IR-L group, only 4 patients died (1 CV event). Patients in the IR-H group experienced significantly higher CV mortality (hazard ratio: 9.02; 95% CI: 1.13 to 72.2; p = 0.04). Even after adjustments for age, systolic blood pressure, body mass index, C-reactive protein, triglycerides, resistin, and leptin, HOMA-IR remained an independent predictor of CV mortality (hazard ratio: 14.8; 95% CI: 1.22 to 179.1; p = 0.03).ConclusionsInsulin resistance assessed using HOMA-IR was an independent predictor of CV morbidity and mortality in a cohort of nondiabetic patients on PD. Insulin resistance is a modifiable risk factor; the reduction of insulin resistance may reduce CV risk and improve survival in this group of patients.

scholarly journals Impact of donor, recipient and matching on survival after high emergency lung transplantation in France

2019 ◽  
Vol 54 (5) ◽  
pp. 1900096 ◽  
Author(s):  
Arnaud Roussel ◽  
Edouard Sage ◽  
Gilbert Massard ◽  
Pascal-Alexandre Thomas ◽  
Yves Castier ◽  
...  
Keyword(s):  
Lung Transplantation ◽  
Adverse Outcome ◽  
Univariate Analysis ◽  
Multivariate Model ◽  
Hazard Ratio ◽  
Administrative Database ◽  
National Study ◽  
Term Survival ◽  
Risk Of Death ◽  
The Impact

IntroductionSince July 2007, the French high emergency lung transplantation (HELT) allocation procedure prioritises available lung grafts to waiting patients with imminent risk of death. The relative impacts of donor, recipient and matching on the outcome following HELT remain unknown. We aimed at deciphering the relative impacts of donor, recipient and matching on the outcome following HELT in an exhaustive administrative database.MethodsAll lung transplantations performed in France were prospectively registered in an administrative database. We retrospectively reviewed the procedures performed between July 2007 and December 2015, and analysed the impact of donor, recipient and matching on overall survival after the HELT procedure by fitting marginal Cox models.ResultsDuring the study period, 2335 patients underwent lung transplantation in 11 French centres. After exclusion of patients with chronic obstructive pulmonary disease/emphysema, 1544 patients were included: 503 HELT and 1041 standard lung transplantation allocations. HELT was associated with a hazard ratio for death of 1.41 (95% CI 1.22–1.64; p<0.0001) in univariate analysis, decreasing to 1.32 (95% CI 1.10–1.60) after inclusion of recipient characteristics in a multivariate model. A donor score computed to predict long-term survival was significantly different between the HELT and standard lung transplantation groups (p=0.014). However, the addition of donor characteristics to recipient characteristics in the multivariate model did not change the hazard ratio associated with HELT.ConclusionsThis exhaustive French national study suggests that HELT is associated with an adverse outcome compared with regular allocation. This adverse outcome is mainly related to the severity status of the recipients rather than donor or matching characteristics.

Obesity Does Not Impact Outcomes for Appendicitis

2012 ◽  
Vol 78 (2) ◽  
pp. 254-257 ◽  
Author(s):  
Daniel A. DeUgarte ◽  
Rebecca Stark ◽  
Amy H. Kaji ◽  
Arezou Yaghoubian ◽  
Amy Tolan ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Univariate Analysis ◽  
Laparoscopic Approach ◽  
Infectious Complications ◽  
Complication Rates ◽  
Obese Patients ◽  
Lower Complication ◽  
Abstract Data ◽  
Nonobese Patients ◽  
The Impact

Obesity has long been considered a risk factor for surgery. The purpose of this study was to evaluate the impact of obesity on outcomes after appendectomy. A retrospective study was performed using discharge abstract data obtained from patients with documented body mass index (BMI) undergoing appendectomy for appendicitis (n = 2919). Complications and length of stay for different BMI categories were compared. Obese patients (BMI > 30 kg/m2) had similar rates of perforation (20%) and were as likely to undergo a laparoscopic approach (85%) as nonobese patients. On multivariable and univariate analysis, no significant differences were observed when comparing obese and nonobese patients for the outcomes of length of stay, infectious complications, and need for readmission. On multivariate analysis, laparoscopy predicted lower complication rates and decreased length of stay. In this study, obesity did not significantly impact rates of perforation, operative approach, length of stay, infectious complications, or readmission.

The Impact of Social Support on the Survival of Chinese Peritoneal Dialysis Patients

2008 ◽  
Vol 28 (3) ◽  
pp. 252-258 ◽  
Author(s):  
Cheuk-Chun Szeto ◽  
Kai-Ming Chow ◽  
Bonnie Ching-Ha Kwan ◽  
Man-Ching Law ◽  
Kwok-Yi Chung ◽  
...  
Keyword(s):  
Social Support ◽  
Peritoneal Dialysis ◽  
Rank Test ◽  
Actuarial Survival ◽  
Dialysis Adequacy ◽  
Technique Survival ◽  
Risk Of Death ◽  
Log Rank Test ◽  
Point Increase ◽  
The Impact

Background Social support is an independent risk factor for mortality among new hemodialysis patients. We evaluated the effect of social support on the outcome of Chinese peritoneal dialysis (PD) patients. Methods We studied 167 prevalent PD patients. They completed the Medical Outcomes Study Social Support Survey, Chinese Version (MOS-SSS-C) questionnaire. Patients were followed for 1 year. Outcome measures included change in nutritional status, hospitalization, and technique and actuarial patient survival. Results Actuarial survival was 57.1%, 72.7%, 85.3%, and 88.6% for MOS-SSS-C total score quartiles I, II, III, and IV, respectively (log rank test, p = 0.037). Technique survival was 57.1%, 81.9%, 91.9%, and 91.4% (log rank test, p = 0.0044). By multivariate analysis with the Cox proportional hazard model to adjust for confounders, every 1 point increase in MOS-SSS-C total score was associated with a 0.6% [95% confidence interval (CI) 0.2% – 0.9%, p = 0.003] reduction in the risk of death and a 0.5% (95%CI 0.1% – 1.0%, p = 0.037) reduction in the risk of technique failure. The MOS-SSS-C score had no significant effect on change in nutritional or dialysis adequacy indices, hospitalization, or number of peritonitis episodes in 1 year. Conclusion The degree of social support is an important predictor of actuarial and technique survival in Chinese PD patients. Measures to enhance social support may represent an easily achievable means of improving the clinical outcome of PD patients.

Impact of obesity in patients with metastatic urothelial carcinoma.

2015 ◽  
Vol 33 (7_suppl) ◽  
pp. 346-346
Author(s):  
Amanda Leiter ◽  
John Doucette ◽  
Susanne Krege ◽  
Chia-Chi Lin ◽  
Noah M. Hahn ◽  
...  
Keyword(s):  
Adverse Events ◽  
Urothelial Cancer ◽  
Normal Weight ◽  
Phase Iii ◽  
Survival Outcomes ◽  
Similar Response ◽  
Obese Patients ◽  
Metastatic Urothelial Cancer ◽  
Significant Difference ◽  
The Impact

346 Background: Obesity has been associated with worse outcomes in patients with clinically localized urothelial cancer. However, the impact of obesity on outcomes of patients with metastatic disease has not previously been evaluated. Methods: Data from 537 patients were aggregated from eight phase II and phase III clinical trials investigating first-line cisplatin-based combination therapy in metastatic urothelial cancer. Chemotherapy regimen, adverse events, treatment response, and survival outcomes were compared across body mass index (BMI) and body surface area (BSA) categories. Results: BMI was classified according to WHO criteria (<18.5 underweight (4.1 % of patients), 18.5-24.99 normal weight (42.8%), 25-29.99 overweight (41.0%), >30 obese (12.1%)). BSA was classified as either below (56.8% of patients) or greater than or equal to (43.2%) the European average (1.91 m2 for males and 1.71 m2 for females). There was no significant difference in number of chemotherapy cycles across BMI and BSA categories. Patients’ treatment regimens significantly differed across BMI (p=0.02) and BSA (p<0.01) categories, with patients with higher BMI category and average or above BSA more likely to receive gemcitabine-cisplatin-based therapy rather than MVAC (methotrexate, vinblastine, doxorubicin, and cisplatin)-based or other therapy regimens. There was no significant difference in adverse events across BMI categories, but the incidence of embolic events was significantly higher in patients with an average or higher BSA (6.6%) than those with a lower than average BSA (2.7%) (p=0.03). There was no significant difference in response rate or survival outcomes (overall and progression-free) amongst BMI and BSA categories. Conclusions: Obese patients with metastatic urothelial cancer on cisplatin-based therapies have similar response rates and survival outcomes to non-obese patients. Toleration of cisplatin-based therapy is similar across BMI and BSA categories, with the exception of a higher incidence of embolic events in patients with an above average BSA.

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