Obesity is associated with worse oncological outcomes in patients treated with radical cystectomy
Notice bibliographique
Résumé
What's known on the subject? and What does the study add? Little is known on the association between obesity and urothelial carcinoma of the bladder ( UCB ). Most studies have shown that higher body mass index ( BMI ) is associated with higher rates of perioperative complications. Only one study specifically investigated obesity and bladder cancer‐specific outcomes and reported no significant association between higher BMI and disease‐specific survival in patients with UCB treated with radical cystectomy. However, that study was limited by its small sample size and a high rate of preoperative therapies. In contrast to the only previous study evaluating the association of BMI with oncological outcomes in UCB , we found that obesity ( BMI ≥30 kg/m 2 ) was associated with features of biologically aggressive UCB and clinical outcomes after radical cystectomy and, even when adjusting for the effects of standard clinicopathological features, obesity remained an independent predictor of cancer recurrence, cancer‐specific mortality and overall mortality. Objective To investigate the association between body mass index ( BMI ) and oncological outcomes in patients after radical cystectomy ( RC ) for urothelial carcinoma of the bladder ( UCB ) in a large multi‐institutional series. Patients and Methods Data were collected from 4118 patients treated with RC and pelvic lymphadenectomy for UCB . Patients receiving preoperative chemotherapy or radiotherapy were excluded. Univariable and multivariable models tested the effect of BMI on disease recurrence, cancer‐specific mortality and overall mortality. BMI was analysed as a continuous and categorical variable (<25 vs 25–29 vs ≥30 kg/m 2 ). Results Median BMI was 28.8 kg/m 2 (interquartile range 7.9); 25.3% had a BMI <25 kg/m 2 , 32.5% had a BMI between 25 and 29.9 kg/m 2 , and 42.2% had a BMI ≥30 kg/m 2 . Patients with a higher BMI were older ( P < 0.001), had higher tumour grade ( P < 0.001), and were more likely to have positive soft tissue surgical margins ( P = 0.006) compared with patients with lower BMI . I n multivariable analyses that adjusted for the effects of standard clinicopathological features, BMI >30 was associated with higher risk of disease recurrence (hazard ratio ( HR ) 1.67, 95% confidence interval ( CI ) 1.46–1.91, P < 0.001), cancer‐specific mortality ( HR 1.43, 95% CI 1.24–1.66, P < 0.001), and overall mortality ( HR 1.81, CI 1.60–2.05, P < 0.001). Themain limitation is the retrospective design of the study. Conclusions Obesity is associated with worse cancer‐specific outcomes in patients treated with RC for <jats:
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Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».