title: Prognostic Value of Body Mass Index According to Histologic Subtype in Nonmetastatic Renal Cell Carcinoma: A Large Cohort Analysis.
abstract: OBJECTIVE
  The objective of our study was to assess the prognostic value of body mass index (BMI) according to histologic subtype in nonmetastatic renal cell carcinoma (RCC), based on a large multicenter experience.
  
  
  METHODS
  A total of 2769 patients with nonmetastatic RCC at the time of surgery were enrolled from 5 Korean institutions between 1999 and 2011. BMI was used as a continuous variable and was categorized according to the World Health Organization recommendation for Asians into normal weight (≥ 18.5 and < 23 kg/m(2)) and overweight and obese (≥ 23 kg/m(2)).
  
  
  RESULTS
  In patients with clear cell variant, increased BMI was associated with higher recurrence-free survival (RFS) or cancer-specific survival (CSS) rates by multivariate analyses (hazard ratio [HR] of RFS, 0.940; P = .007; HR of CSS, 0.875; P < .001). On the other hand, increased BMI in patients with chromophobe variant was associated with lower RFS or CSS rates, unlike in patients with clear cell variant (HR of RFS, 1.317, P = .011; HR of CSS, 1.320; P = .031). In patients with papillary variant, BMI was not associated with RFS or CSS (P > .05 for each).
  
  
  CONCLUSIONS
  Our results showed that increased BMI was a favorable prognostic factor in patients with clear cell variant. However, increased BMI was a poor prognostic factor in patients with chromophobe variant and was not associated with prognosis in those with papillary variant. Our study suggests that the association between BMI and RCC prognosis may differ by histologic subtype.
authors.affiliation: Department of Urology, College of Medicine, Hallym University, Chuncheon, Korea.
authors.forename: Won Ki
authors.initials: WK
authors.lastname: Lee
authors.affiliation: Department of Urology, College of Medicine, Seoul National University, Seoul, Korea.
authors.forename: Sung Kyu
authors.initials: SK
authors.lastname: Hong
authors.affiliation: Department of Urology, College of Medicine, Seoul National University, Seoul, Korea.
authors.forename: Sangchul
authors.initials: S
authors.lastname: Lee
authors.affiliation: Department of Urology, College of Medicine, Seoul National University, Seoul, Korea.
authors.forename: Cheol
authors.initials: C
authors.lastname: Kwak
authors.affiliation: Department of Urology, College of Medicine, Seoul National University, Seoul, Korea.
authors.forename: Jong Jin
authors.initials: JJ
authors.lastname: Oh
authors.affiliation: Department of Urology, College of Medicine, Seoul National University, Seoul, Korea.
authors.forename: Chang Wook
authors.initials: CW
authors.lastname: Jeong
authors.affiliation: Department of Urology, College of Medicine, Chungbuk National University, Cheongju, Korea.
authors.forename: Yong June
authors.initials: YJ
authors.lastname: Kim
authors.affiliation: Department of Urology, College of Medicine, Korea University, Seoul, Korea.
authors.forename: Seok Ho
authors.initials: SH
authors.lastname: Kang
authors.affiliation: Department of Urology, College of Medicine, Catholic University, Seoul, Korea.
authors.forename: Sung Hoo
authors.initials: SH
authors.lastname: Hong
authors.affiliation: Department of Urology, College of Medicine, Seoul National University, Seoul, Korea. Electronic address: ssbyun@snubh.org.
authors.forename: Seok-Soo
authors.initials: SS
authors.lastname: Byun
mesh_terms: D000328:Adult; D000368:Aged; D015992:Body Mass Index; D002292:Carcinoma, Renal Cell / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000473:pathology* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications*; D011379:Prognosis; D016019:Survival Analysis
keywords: Body mass index; Histology; Obesity; Renal cell carcinoma; Survival