• Media type: E-Article
  • Title: Influence of Body Mass Index on Clinical Outcome Parameters, Complication Rate and Survival after Radical Cystectomy: Evidence from a Prospective European Multicentre Study
  • Contributor: Gierth, Michael; Zeman, Florian; Denzinger, Stefan; Vetterlein, Malte W.; Fisch, Margit; Bastian, Patrick J.; Syring, Isabella; Ellinger, Jörg; Müller, Stephan C.; Herrmann, Edwin; Gilfrich, Christian; May, Matthias; Pycha, Armin; Wagenlehner, Florian M.; Vallo, Stefan; Bartsch, Georg; Haferkamp, Axel; Grimm, Marc-Oliver; Roigas, Jan; Protzel, Chris; Hakenberg, Oliver W.; Fritsche, Hans-Martin; Burger, Maximilian; Aziz, Atiqullah;
  • Published: S. Karger AG, 2018
  • Published in: Urologia Internationalis, 101 (2018) 1, Seite 16-24
  • Language: English
  • DOI: 10.1159/000488466
  • ISSN: 0042-1138; 1423-0399
  • Origination:
  • Footnote:
  • Description: <b><i>Background/Aims/Objectives:</i></b> To evaluate the influence of body mass index (BMI) on complications and oncological outcomes in patients undergoing radical cystectomy (RC). <b><i>Methods:</i></b> Clinical and histopathological parameters of patients have been prospectively collected within the “PROspective MulticEnTer RadIcal Cystectomy Series 2011”. BMI was categorized as normal weight (<25 kg/m<sup>2</sup>), overweight (≥25–29.9 kg/m<sup>2</sup>) and obesity (≥30 kg/m<sup>2</sup>). The association between BMI and clinical and histopathological endpoints was examined. Ordinal logistic regression models were applied to assess the influence of BMI on complication rate and survival. <b><i>Results:</i></b> Data of 671 patients were eligible for final analysis. Of these patients, 26% (<i>n</i> = 175) showed obesity. No significant association of obesity on tumour stage, grade, lymph node metastasis, blood loss, type of urinary diversion and 90-day mortality rate was found. According to the ­American Society of Anesthesiologists score, local lymph node (NT) stage and operative case load patients with higher BMI had significantly higher probabilities of severe complications 30 days after RC (<i>p</i> = 0.037). The overall survival rate of obese patients was superior to normal weight patients (<i>p</i> = 0.019). <b><i>Conclusions:</i></b> There is no evidence of correlation between obesity and worse oncological outcomes after RC. While obesity should not be a parameter to exclude patients from cystectomy, surgical settings need to be aware of higher short-term complication risks and obese patients should be counselled ­accordingly.