High-grade T1 NMIBC: high BMI tied to recurrence, progression

  • Ferro M & al.
  • World J Urol
  • 10 Jul 2018

  • curated by Deepa Koli
  • Univadis Clinical Summaries
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Takeaway

  • Overweight (BMI, 25-29.9 kg/m2) and obesity (BMI, ≥30 kg/m2) were associated with higher risk for progression and recurrence vs normal weight (BMI, 18.5-24.99 kg/m2) in patients with T1 nonmuscle-invasive bladder cancer (NMIBC) who underwent transurethral resection of the bladder tumor (TURBT) and received adjuvant Bacillus Calmette-Guérin (BCG) immunotherapy.

 Why this matters

  • BMI is a modifiable risk factor.

Study design

  • 1155 patients with T1 high-grade NMIBC underwent TURBT and adjuvant intravesical BCG immunotherapy.
  • Funding: None disclosed.

Key results

  • After re-TURBT (performed within 6 weeks of first TURBT), 288 patients had residual disease.
  • 678 patients experienced recurrence and 303 progressed to muscle-invasive cancer.
  • Risk for recurrence was significantly higher in overweight (HR=4; P<.001 and obese patients p vs normal-weight patients.>
  • Tumor size (HR=1.3; P=.001) and multifocality (HR=1.24; P=.004) were independent risk factors for recurrence (Concordance [c]-index for multivariable model, 55.98); adding BMI to the model increased c-index to 65.88.
  • Risk for progression was significantly increased in overweight (HR=2.52; P<.001 and obese patients p vs normal-weight patients.>
  • Tumor size (HR=1.63; P<.001 multifocality p=".01)," and concomitant carcinoma in situ were significant risk factors for progression adding bmi increased c-index by>

Limitations

  • Retrospective design.

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