scholarly journals Associations between body mass index and bladder cancer survival: Is the obesity paradox short-lived?

2021 ◽  
Vol 16 (5) ◽  
Author(s):  
Fernanda Arthuso ◽  
Adrian S. Fairey ◽  
Normand G. Boule ◽  
Kerry S. Courneya
Keyword(s):  
Body Mass Index ◽  
Overall Survival ◽  
Bladder Cancer ◽  
Cancer Patients ◽  
Radical Cystectomy ◽  
Body Mass ◽  
Cox Regression ◽  
Obesity Paradox ◽  
Step Function ◽  
Time Segment

Introduction: We investigated the associations of pre-surgical body mass index (BMI) with bladder cancer outcomes in patients treated with radical cystectomy. Methods: We retrospectively analyzed data from 488 bladder cancer patients treated with radical cystectomy between 1994 and 2007 and followed up until 2016. Cox regression with step function (time-segment analysis) was conducted for overall survival because the proportional hazard assumption was violated. Results: Of 488 bladder cancer patients, 155 (31.8%) were normal weight, 186 (38.1%) were overweight, and 147 (30.1%) were obese. During the median followup of 59.5 months, 363 (74.4%) patients died, including 197 (40.4%) from bladder cancer. In adjusted Cox regression analyses, BMI was not significantly associated with bladder cancer-specific survival for overweight (hazard ratio [HR] 0.79, 95% confidence interval [CI] 0.57–1.10, p=0.16) or obese (HR 0.76, 95% CI 0.52–1.09, p=0.13) patients. In the Cox regression with step function for overall survival, the time interaction was significant overall (p=0.020) and specifically for overweight patients (p=0.006). In the time-segment model, the HR for overweight during the first 63 months was 0.66 (95% CI 0.49–0.90, p=0.008), whereas it was 1.41 (95% CI 0.89–2.23, p=0.14) after 63 months. Although not statistically significant, a similar pattern was observed for obese patients. Conclusions: Our findings suggest that overweight and obese bladder cancer patients had better outcomes within the first five years after radical cystectomy; however, there were no differences in longer-term survival. These data suggest that the obesity paradox in bladder cancer patients treated with radical cystectomy may be short-lived.

483 PROGNOSTIC VALUE OF BODY MASS INDEX IN BLADDER CANCER PATIENTS RECEIVED RADICAL CYSTECTOMY

2011 ◽  
Vol 185 (4S) ◽  
Author(s):  
Myungchan Park ◽  
Chunwoo Lee ◽  
Dalsan You ◽  
Kwang Hyun Kim ◽  
Kyung Hyun Moon ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Bladder Cancer ◽  
Cancer Patients ◽  
Radical Cystectomy ◽  
Body Mass ◽  
Prognostic Value

The timing from perioperative chemotherapy and disease recurrence could have clinical impact on survival in bladder cancer patients treated with salvage chemotherapy.

2019 ◽  
Vol 37 (7_suppl) ◽  
pp. 444-444
Author(s):  
Eiji Kikuchi ◽  
Nozomi Hayakawa ◽  
Koichirou Ogihara ◽  
Minami Omura ◽  
Ryuichi Mizuno ◽  
...  
Keyword(s):  
Overall Survival ◽  
Bladder Cancer ◽  
Cancer Patients ◽  
Radical Cystectomy ◽  
Cox Regression ◽  
Prognostic Indicator ◽  
Disease Recurrence ◽  
Salvage Chemotherapy ◽  
Perioperative Chemotherapy ◽  
Cox Regression Analysis

444 Background: Our aim was to clarify whether the duration between perioperative chemotherapy and disease recurrence could affect therapeutic efficacy of salvage chemotherapy in bladder cancer patients treated with radical cystectomy. Methods: We retrospectively identified 201 patients treated with radical cystectomy and perioperative chemotherapy of neoadjuvant chemotherapy (NAC) and/or adjuvant chemotherapy (AC) for bladder cancer at our 7 institutions between 2003 and 2015. Of them 56 patients received salvage chemotherapy for disease recurrence and were included in the present analysis. We classified these patients according to the time from perioperative chemotherapy received to disease recurrence ( < 12 months, 12-24 months, and 24 < months) and compared their clinical characteristics and survival outcomes. Results: Overall, 33, 14, and 9 patients developed disease recurrence in < 12 months, 12-24 months, and < 24 months, respectively after perioperative chemotherapy. Patients in the 12-24 months group had a higher smoking rate compared to those in the other two groups, and were higher rate of female in comparison to the < 24 months group. Twenty-four (42.8%) patients received NAC alone, 23 (41.1%) received AC alone, and 9 (16.1%) received both NAC and AC. Twenty-two (66.7%), 9 (64%), and 4 (44.4%) patients received NAC in the < 12 months group, the 12-24 months group, and the < 24 months group, respectively. Furthermore, 19 (57.6%), 7 (50%), and 6 (66.7%) patients received AC in the < 12 months group, the 12-24 months group, and the < 24 months group, respectively. The 5 year overall survival in the < 12 months group was 26.6%, which was significantly lower than those in the 12-24 months group (51.1%, p < 0.001) and in the 24 months group (46.9%, p = 0.014). Multivariate Cox regression analysis revealed that disease recurrence after perioperative chemotherapy within 12 months was the only independent prognostic indicator for overall death (p = 0.032). Conclusions: Bladder cancer patients with disease recurrence within 12 months from their perioperative chemotherapy have a worse overall survival after salvage chemotherapy.

scholarly journals Development of a novel prognostic signature for predicting the overall survival of bladder cancer patients

2020 ◽  
Vol 40 (6) ◽  
Author(s):  
Huamei Tang ◽  
Lijuan Kan ◽  
Tong Ou ◽  
Dayang Chen ◽  
Xiaowen Dou ◽  
...  
Keyword(s):  
Dna Methylation ◽  
Overall Survival ◽  
Bladder Cancer ◽  
Cancer Patients ◽  
Cox Regression ◽  
Test Group ◽  
Training Group ◽  
The Cancer Genome Atlas ◽  
Methylation Site ◽  
Cox Regression Analysis

Abstract Background: Bladder cancer is one of the most common malignancies. So far, no effective biomarker for bladder cancer prognosis has been identified. Aberrant DNA methylation is frequently observed in the bladder cancer and holds considerable promise as a biomarker for predicting the overall survival (OS) of patients. Materials and methods: We downloaded the DNA methylation and transcriptome data for bladder cancer from The Cancer Genome Atlas (TCGA), a public database, screened hypo-methylated and up-regulated genes, similarly, hyper-methylation with low expression genes, then retrieved the relevant methylation sites. Cox regression analysis was used to identify a nine-methylation site signature of a training group. Predictive ability was validated in a test group by receiver operating characteristic (ROC) analysis. Results: We identified nine bladder cancer-specific methylation sites as potential prognostic biomarkers and established a risk score system based on the methylation site signature to evaluate the OS. The performance of the signature was accurate, with area under curve was 0.73 in the training group and 0.71 in the test group. Taking clinical features into consideration, we constructed a nomogram consisting of the nine-methylation site signature and patients’ clinical variables, and found that the signature was an independent risk factor. Conclusions: Overall, the significant nine methylation sites could be novel prediction biomarkers, which could aid in treatment and also predict the overall survival likelihoods of bladder cancer patients.

1111: The Effect of Body Mass Index (BMI) on the Quality and Morbidity of Radical Cystectomy for Bladder Cancer

2005 ◽  
Vol 173 (4S) ◽  
pp. 301-301
Author(s):  
Karim Touijer ◽  
Daniel Cho ◽  
Bernard H. Bochner ◽  
Harry W. Herr ◽  
Guido Dalbagni ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Bladder Cancer ◽  
Radical Cystectomy ◽  
Body Mass

The effects of body mass index on curative radiation therapy in cervical carcinoma: An analysis of complications and survival

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e16520-e16520
Author(s):  
P. H. Thaker ◽  
F. Gao ◽  
I. Zighelboim ◽  
M. A. Powell ◽  
J. S. Rader ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Cervical Cancer ◽  
Overall Survival ◽  
Radiation Therapy ◽  
Cancer Patients ◽  
Body Mass ◽  
Disease Free Survival ◽  
Free Survival ◽  
Underweight Patients ◽  
Disease Free

e16520 Background: Recently, the rates of obese and overweight patients have increased dramatically. However, the effect of body mass index (BMI) have not been evaluated in treatment outcomes for patients with advanced stage cervical cancer receiving definitive chemotherapy and radiation therapy, and is the purpose of this study. Methods: After obtaining approval from the Washington University Human Studies Protection Office, a retrospective cohort study (n = 321) was performed on all cervical cancer patients with stage IB1 with positive lymph nodes or ≥ stage IB2 from January 1998 to January 2008. The median duration of follow up was 60 months. BMI was calculated using the National Institute of Health online BMI calculator. Main outcomes were overall survival, disease free survival, and radiation complications such as radiation enteritis/cystitis, bowel obstruction, and fistula formation. Univariate and multivariate analyses were performed, and Kaplan-Meier curves were generated. Results: Underweight patients (BMI<18.5 kg/m2) compared to normal weight (BMI = 18.5–25 kg/m2) and overweight/obese (>25 kg/m2) have a higher actuarial complication rate (p = 0.0137). Regardless of weight there is no difference in disease free survival. However, underweight patients have a significantly poorer overall survival than those patients with a higher BMI (>18.5 kg/m2) (p < 0.001). Conclusions: Underweight patients have a diminished overall survival compared to normal or obese cervical cancer patients. This is of clinical relevance when counseling underweight cervical cancer patients who will be cured of the disease with chemotherapy and radiation therapy, but have a significant risk of suffering potentially fatal complications from treatment. Further study needs to be done to elucidate this relationship further. No significant financial relationships to disclose.

Systemic therapy and overall survival trends in patients with non-urothelial histologic variants of muscle invasive bladder cancer undergoing radical cystectomy.

2017 ◽  
Vol 35 (6_suppl) ◽  
pp. 376-376 ◽  
Author(s):  
Shreyas Joshi ◽  
Elizabeth Handorf ◽  
Andres Correa ◽  
Alexander Kutikov ◽  
Benjamin T. Ristau ◽  
...  
Keyword(s):  
Overall Survival ◽  
Bladder Cancer ◽  
Radical Cystectomy ◽  
Survival Benefit ◽  
Cox Regression ◽  
Invasive Bladder Cancer ◽  
Muscle Invasive Bladder Cancer ◽  
Kaplan Meier ◽  
Muscle Invasive

376 Background: Histological variants of urothelial carcinoma (UC) of the bladder have a poorer prognosis than histologically pure UC, and the role of neoadjuvant chemotherapy (NAC) in this group is unclear. Our objective was to evaluate NAC practice patterns and survival outcomes in patients with histologic variants undergoing radical cystectomy (RC). Methods: Patients with cT2-4N0-3M0 muscle invasive bladder cancer (MIBC) who underwent RC from 2003-2012 were selected from the National Cancer Database (NCDB). Patients were categorized by histology code as pure UC or histologic variants. Adjusting for patient and clinical characteristics, generalized estimating equations were used to test the association between histology and receipt of NAC. The association between receipt of NAC and overall survival (OS) was evaluated using Kaplan Meier curves and Cox regression models. Results: In 19,976 patients meeting inclusion criteria, receipt of NAC in histologic variants was less (11-14%) than in pure UC (22%), with the exception of micropapillary disease (23%) (Table). Median OS was lower in variant histologies than for pure UC (8.4 – 30.2 vs. 37.6 months). Receipt of NAC was associated with improved survival compared to RC or RC+adjuvant chemotherapy in patients with pure UC (HR 0.91, p=0.0016). There was no evidence of a survival benefit for NAC in the variant histologies, or that treatment effects differed by histology (P-val for interaction=0.84). Conclusions: In the NCDB, a substantial proportion of patients (13%) with histologic variants of MIBC undergoing RC receive NAC in the absence of a proven survival benefit. Clinical trials inclusive of patients with variant histologies are necessary to elucidate the role of NAC prior to RC. [Table: see text]

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