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Effect of Body Mass Index and Hypertension on the Prognosis of Upper Tract Urothelial Carcinoma After Radical Nephroureterectomy

대한비뇨기종양학회지 2020년 18권 3호 p.201 ~ 208
이민성, 송상헌, Kim Hak-Ju, 이상철, 홍성규, 변석수, 이상은, 오종진,
소속 상세정보
이민성 ( Lee Min-Seung ) - Seoul National University Bundang Hospital Department of Urology
송상헌 ( Song Sang-Hun ) - Seoul National University Bundang Hospital Department of Urology
 ( Kim Hak-Ju ) - Seoul National University Bundang Hospital Department of Urology
이상철 ( Lee Sang-Chul ) - Seoul National University Bundang Hospital Department of Urology
홍성규 ( Hong Sung-Kyu ) - Seoul National University Bundang Hospital Department of Urology
변석수 ( Byun Seok-Soo ) - Seoul National University Bundang Hospital Department of Urology
이상은 ( Lee Sang-Eun ) - Seoul National University Bundang Hospital Department of Urology
오종진 ( Oh Jong-Jin ) - Seoul National University Bundang Hospital Department of Urology

Abstract


Purpose: To investigate the impact of preoperative underlying hypertension (HTN) and body mass index (BMI) on oncologic outcomes in patients with upper tract urothelial carcinoma (UTUC) who underwent radical nephroureterectomy (RNUx).

Materials and Methods: From May 2003 to December 2018, 453 UTUC patients who underwent RNUx at a single institution were enrolled in the study. All patients were divided into 2 groups according to preoperative HTN and BMI (cutoff 24 kg/m2) and perioperative parameters and recurrence outcomes were compared. Multivariate Cox proportional hazard analysis was performed to identify the significance of HTN and BMI regarding UTUC recurrence.

Results: Among a total 453 UTUC patients, 233 (51.4%) had HTN, and 222 (49.0%) had BMI ≥24 kg/m2. The HTN versus no-HTN group had similar perioperative outcomes, except for the rate of diabetes (p<0.001). The high-BMI versus low-BMI group had similar outcomes, except for the prevalence of HTN (p=0.026). During median follow-up of 23 months, 5-year recurrence-free survival rates were 76.2% in the HTN group and 79.9% in the non-HTN group (p=0.002), and 77.3% in the low-BMI group and 79.0% in the high-BMI group (p=0.007). Multivariate analysis showed that BMI (hazard ratio [HR], 0.740; p=0.046), and HTN (HR, 1.687; p=0.005) were significant predictors of cancer recurrence.

Conclusions: Among UTUC patients who underwent RNUx, patients with HTN and low-BMI showed worse prognosis regarding cancer recurrence. To validate our results, the mechanisms of association between HTN, BMI, and UTUC should be investigated in further prospective studies.

키워드

Upper tract urothelial carcinoma; Body mass index; Hypertension; Survival

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