Background: The relationship between adiposity and renal cell carcinoma is poorly understood. Prior studies have suggested body mass index (BMI) 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 ≥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% confidence interval (CI) 0.31–0.81] and BMI ≥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 ≥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 Epidemiol Biomarkers Prev; 25(9); 1326–32. ©2016 AACR.
This article is featured in Highlights of This Issue, p. 1279
Note: ClinicalTrials.gov Identifier: NCT00087022
- Received March 15, 2016.
- Revision received June 21, 2016.
- Accepted July 4, 2016.
- ©2016 American Association for Cancer Research.