腎細胞がん術後の肥満は生存期間改善

腎細胞がん術後患者では、肥満は生存期間改善と術後合併症増加と関連するという論文を紹介します。

Åse J. Rogde, et al: Obesity is associated with an improved cancer-specific survival, but an increased rate of postoperative complications after surgery for renal cell carcinoma. Scandinavian Journal of Urology and Nephrology, Posted online on April 25, 2012. (doi:10.3109/00365599.2012.678382)

抄録しか読めていないので詳細不明ですが、タイトル通りの結論です。肥満はいくつかのがんで発症率を高めたり、消化器がんの死亡率を高めるリスクですが、この研究では予後良好となっています。おそらく筋肉量、悪液質の有無・程度の関連だと思います。

Abstract
Objective. This study aimed to assess the impact of preoperative body mass index (BMI) on postoperative complications, cancer-specific survival (CSS) and overall survival (OS) in patients operated for renal cell carcinoma (RCC).

Material and methods. The study included 397 patients with BMI values, who underwent surgery for RCC between 1 January 1997 and 31 December 2010. Obese patients (BMI > 30 kg/m2) were compared to non-obese patients (BMI < 30 kg/m2) in regard to CSS and OS. A Cox proportional hazard model was used for the multivariate survival analyses. The mean age of the patients was 62.1 years. There were 259 males (65%) and 325 patients (82%) were non-obese. Mean BMI was 26 kg/m2.

Results. In the total material, CSS was 94.7% for obese patients and 74.8% for non-obese patients (p = 0.06). The obese group had significantly better CSS in univariate analysis for presumed radically treated disease (pT1–3N0M0). Obesity was a significant protective prognostic factor in multivariate analysis. An accelerating protective effect for CSS was found with increasing levels of BMI. In regard to OS, no difference was found between the two groups. Obese patients had a significantly lower age, and a higher rate of diabetes mellitus, hypertension and incidental detection. Obese patients had a significantly higher total incidence of postoperative complications, but not surgery-related complications.

Conclusions. In this material, increasing BMI was associated with improved CSS for presumed radically treated patients. However, obese patients had a higher total rate of postoperative complications.