Photo Credit: Liudmila Chernetska
The following is a summary of “Unraveling the BMI paradox in different renal cortical tumors: insights from the INMARC registry,” published in the February 2024 issue of Oncology by Saitta et al.
This retrospective multicenter analysis aimed to examine the influence of body mass index (BMI) on survival outcomes across various histologies and stages of renal cell carcinoma (RCC).
The researchers analyzed data from 3,880 patients, including clear cell (ccRCC) and non-clear cell RCC (non-ccRCC). Obesity was defined based on WHO criteria (non-Asian BMI >30 Kg/m2, Asian BMI >27.5 Kg/m2). Multivariable analysis (MVA) using Cox regression models assessed all-cause mortality (ACM), cancer-specific mortality (CSM), and recurrence.
Among the patients, 1,373 (35.3%) were classified as obese. Of these, 2,895 (74.6%) had ccRCC, while 985 (25.3%) had non-ccRCC, including chromophobe RCC (chRCC) 246 (24.9%), papillary RCC (pRCC) 469 (47.6%), and collecting duct RCC (vhRCC) 270 (27.4%). In ccRCC, obesity was associated with reduced risk of ACM, CSM, and recurrence (HR 0.80, P = 0.044; HR 0.71, P = 0.039; HR 0.73, P = 0.012, respectively). However, in non-ccRCC, obesity did not correlate with decreased risk of ACM, CSM, or recurrence (P = 0.84, P = 0.53, P = 0.84, respectively). Subset analysis in stage IV ccRCC demonstrated a decreased risk of ACM, CSM, and recurrence associated with obesity (HR 0.68, P = 0.04; HR 0.59, P = 0.01; HR 0.59, P = 0.01, respectively). Conversely, in stage I–III ccRCC, obesity was not associated with improved survival outcomes (P = 0.21; P = 0.30; P = 0.19, respectively).
Contrary to the widely observed “obesity paradox,” their study findings suggest that obesity does not uniformly confer survival advantages in RCC. While non-ccRCC and non-metastatic ccRCC patients with obesity did not experience improved survival, metastatic ccRCC patients with obesity demonstrated better survival outcomes.
Source: sciencedirect.com/science/article/abs/pii/S107814392300412X
