title: Obesity and Outcomes in Patients with Metastatic Urothelial Carcinoma.
abstract: Background:Obesity has been associated with worse outcomes in patients with clinically localized urothelial cancer. However, this impact has not been evaluated in metastatic disease.Objective:To assess the impact of obesity on outcomes of patients with metastatic urothelial cancer.Methods:Data from 537 patients were aggregated from eight phase II and phase III clinical trials investigating first-line cisplatin-based combination therapy in metastatic urothelial cancer. Chemotherapy regimen, adverse events, treatment response, and survival outcomes were compared across body mass index (BMI) and body surface area (BSA) categories.Results:BMI was classified according to WHO criteria (<18.5 underweight, 18.5-24.99 normal weight, 25-29.99 overweight, >30 obese). BSA was classified as either below or greater than or equal to (average for this cohort (1.87 m2for males and 1.66 m2for females). There was no significant difference in number of chemotherapy cycles, adverse events, and response rate or survival outcomes (overall and progression-free) across BMI and BSA categories. There was no significant difference in adverse events across BMI categories, but the incidences of embolic events and renal failure were higher in patients with an average or higher BSA than those with a lower than average BSA (6.6% vs. 3.1% for renal failurep= 0.06; 5.9% vs. 2.7% for renal failure,p= 0.07). There was no significant difference in response rate or survival outcomes (overall and progression-free) amongst BMI and BSA categories.Conclusions:Obese patients with metastatic urothelial cancer on cisplatin-based therapies have similar response rates, survival outcomes, and tolerability of cisplatin-based therapy to non-obese patients.
authors: Department of Medicine, Division of Hematology/Oncology, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
authors: Amanda
authors: A
authors: Leiter
authors: Department of Preventive Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
authors: John
authors: J
authors: Doucette
authors: Urologische Klinik, Alexianer Krefeld GmbH, Krefeld, Germany.
authors: Susan
authors: S
authors: Krege
authors: Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan.
authors: Chia-Chi
authors: CC
authors: Lin
authors: Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
authors: Noah
authors: N
authors: Hahn
authors: HELIOS Hospital, Bad Saarow, Germany.
authors: Thorsten
authors: T
authors: Ecke
authors: Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, AL, USA.
authors: Guru
authors: G
authors: Sonpavde
authors: University of Athens, Athens, Greece.
authors: Aristotle
authors: A
authors: Bamias
authors: Department of Medicine, Division of Hematology/Oncology, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
authors: William K
authors: WK
authors: Oh
authors: Department of Medicine, Division of Hematology/Oncology, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
authors: Matthew D
authors: MD
authors: Galsky
keywords: BMI; BSA; Metastatic bladder cancer; body mass index; body surface area; metastatic urothelial cancer; obesity