An increased body mass index is associated with a worse prognosis in patients administered BCG immunotherapy for T1 bladder cancer

Michele Battaglia, Vincenzo Serretta, Paolo Verze, Estevao Lima, Riccardo Autorino, Matteo Ferro, Riccardo Schiavina, Gennaro Musi, Gilberto L. Almeida, Marco Borghesi, Gabriele Cozzi, Gian Maria Busetto, Mihai Dorin Vartolomei, Antonio Cioffi, Nicolae Crisan, Amelia Cimmino, Ettore De Berardinis, Matteo Muto, Rodolfo Hurle, Giorgio Ivan RussoGiovanni Grimaldi, Abdal Rahman Abu Farhan, Francesco Cantiello, Daniela Terracciano, Sisto Perdonà, Ottavio De Cobelli, Deliu Victor Matei, Pierluigi Bove, Shahrokh Shariat, Savino Di Stasi, Giuseppe Morgia, Vincenzo Mirone, Giorgio Guazzoni, Rocco Damiano, Michele Battaglia, Giuseppe Lucarelli, Paolo Verze

Risultato della ricerca: Article

10 Citazioni (Scopus)

Abstract

The body mass index (BMI) may be associated with an increased incidence and aggressiveness of urological cancers. In this study, we aimed to evaluate the impact of the BMI on survival in patients with T1G3 non-muscle-invasive bladder cancer (NMIBC).A total of 1155 T1G3 NMIBC patients from 13 academic institutions were retrospectively reviewed and patients administered adjuvant intravesical Bacillus Calmette-Gu,rin (BCG) immunotherapy with maintenance were included. Multivariable Cox regression analysis was performed to identify factors predictive of recurrence and progression.After re-TURBT, 288 patients (27.53%) showed residual high-grade NMIBC, while 867 (82.89%) were negative. During follow-up, 678 (64.82%) suffered recurrence, and 303 (30%) progression, 150 (14.34%) died of all causes, and 77 (7.36%) died of bladder cancer. At multivariate analysis, tumor size (hazard ratio [HR]:1.3; p = 0.001), and multifocality (HR:1.24; p = 0.004) were significantly associated with recurrence (c-index for the model:55.98). Overweight (HR: 4; p < 0.001) and obesity (HR:5.33 p < 0.001) were significantly associated with an increased risk of recurrence. Addition of the BMI to a model that included standard clinicopathological factors increased the C-index by 9.9. For progression, we found that tumor size (HR:1.63; p < 0.001), multifocality (HR:1.31; p = 0.01) and concomitant CIS (HR: 2.07; p < 0.001) were significant prognostic factors at multivariate analysis (C-index 63.8). Overweight (HR: 2.52; p < 0.001) and obesity (HR: 2.521 p < 0.001) were significantly associated with an increased risk of progression. Addition of the BMI to a model that included standard clinicopathological factors increased the C-index by 1.9.The BMI could have a relevant role in the clinical management of T1G3 NMIBC, if associated with bladder cancer recurrence and progression. In particular, this anthropometric factor should be taken into account at initial diagnosis and in therapeutic strategy decision making.
Lingua originaleEnglish
pagine (da-a)507-514
Numero di pagine8
RivistaWorld Journal of Urology
Volume37
Stato di pubblicazionePublished - 2019

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Urinary Bladder Neoplasms
Immunotherapy
Bacillus
Body Mass Index
Recurrence
Multivariate Analysis
Obesity
Urologic Neoplasms
Neoplasms
Decision Making
Regression Analysis
Maintenance
Survival
Incidence

All Science Journal Classification (ASJC) codes

  • Urology

Cita questo

An increased body mass index is associated with a worse prognosis in patients administered BCG immunotherapy for T1 bladder cancer. / Battaglia, Michele; Serretta, Vincenzo; Verze, Paolo; Lima, Estevao; Autorino, Riccardo; Ferro, Matteo; Schiavina, Riccardo; Musi, Gennaro; Almeida, Gilberto L.; Borghesi, Marco; Cozzi, Gabriele; Busetto, Gian Maria; Vartolomei, Mihai Dorin; Cioffi, Antonio; Crisan, Nicolae; Cimmino, Amelia; De Berardinis, Ettore; Muto, Matteo; Hurle, Rodolfo; Russo, Giorgio Ivan; Grimaldi, Giovanni; Farhan, Abdal Rahman Abu; Cantiello, Francesco; Terracciano, Daniela; Perdonà, Sisto; De Cobelli, Ottavio; Matei, Deliu Victor; Bove, Pierluigi; Shariat, Shahrokh; Di Stasi, Savino; Morgia, Giuseppe; Mirone, Vincenzo; Guazzoni, Giorgio; Damiano, Rocco; Battaglia, Michele; Lucarelli, Giuseppe; Verze, Paolo.

In: World Journal of Urology, Vol. 37, 2019, pag. 507-514.

Risultato della ricerca: Article

Battaglia, M, Serretta, V, Verze, P, Lima, E, Autorino, R, Ferro, M, Schiavina, R, Musi, G, Almeida, GL, Borghesi, M, Cozzi, G, Busetto, GM, Vartolomei, MD, Cioffi, A, Crisan, N, Cimmino, A, De Berardinis, E, Muto, M, Hurle, R, Russo, GI, Grimaldi, G, Farhan, ARA, Cantiello, F, Terracciano, D, Perdonà, S, De Cobelli, O, Matei, DV, Bove, P, Shariat, S, Di Stasi, S, Morgia, G, Mirone, V, Guazzoni, G, Damiano, R, Battaglia, M, Lucarelli, G & Verze, P 2019, 'An increased body mass index is associated with a worse prognosis in patients administered BCG immunotherapy for T1 bladder cancer', World Journal of Urology, vol. 37, pagg. 507-514.
Battaglia, Michele ; Serretta, Vincenzo ; Verze, Paolo ; Lima, Estevao ; Autorino, Riccardo ; Ferro, Matteo ; Schiavina, Riccardo ; Musi, Gennaro ; Almeida, Gilberto L. ; Borghesi, Marco ; Cozzi, Gabriele ; Busetto, Gian Maria ; Vartolomei, Mihai Dorin ; Cioffi, Antonio ; Crisan, Nicolae ; Cimmino, Amelia ; De Berardinis, Ettore ; Muto, Matteo ; Hurle, Rodolfo ; Russo, Giorgio Ivan ; Grimaldi, Giovanni ; Farhan, Abdal Rahman Abu ; Cantiello, Francesco ; Terracciano, Daniela ; Perdonà, Sisto ; De Cobelli, Ottavio ; Matei, Deliu Victor ; Bove, Pierluigi ; Shariat, Shahrokh ; Di Stasi, Savino ; Morgia, Giuseppe ; Mirone, Vincenzo ; Guazzoni, Giorgio ; Damiano, Rocco ; Battaglia, Michele ; Lucarelli, Giuseppe ; Verze, Paolo. / An increased body mass index is associated with a worse prognosis in patients administered BCG immunotherapy for T1 bladder cancer. In: World Journal of Urology. 2019 ; Vol. 37. pagg. 507-514.
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title = "An increased body mass index is associated with a worse prognosis in patients administered BCG immunotherapy for T1 bladder cancer",
abstract = "The body mass index (BMI) may be associated with an increased incidence and aggressiveness of urological cancers. In this study, we aimed to evaluate the impact of the BMI on survival in patients with T1G3 non-muscle-invasive bladder cancer (NMIBC).A total of 1155 T1G3 NMIBC patients from 13 academic institutions were retrospectively reviewed and patients administered adjuvant intravesical Bacillus Calmette-Gu,rin (BCG) immunotherapy with maintenance were included. Multivariable Cox regression analysis was performed to identify factors predictive of recurrence and progression.After re-TURBT, 288 patients (27.53{\%}) showed residual high-grade NMIBC, while 867 (82.89{\%}) were negative. During follow-up, 678 (64.82{\%}) suffered recurrence, and 303 (30{\%}) progression, 150 (14.34{\%}) died of all causes, and 77 (7.36{\%}) died of bladder cancer. At multivariate analysis, tumor size (hazard ratio [HR]:1.3; p = 0.001), and multifocality (HR:1.24; p = 0.004) were significantly associated with recurrence (c-index for the model:55.98). Overweight (HR: 4; p < 0.001) and obesity (HR:5.33 p < 0.001) were significantly associated with an increased risk of recurrence. Addition of the BMI to a model that included standard clinicopathological factors increased the C-index by 9.9. For progression, we found that tumor size (HR:1.63; p < 0.001), multifocality (HR:1.31; p = 0.01) and concomitant CIS (HR: 2.07; p < 0.001) were significant prognostic factors at multivariate analysis (C-index 63.8). Overweight (HR: 2.52; p < 0.001) and obesity (HR: 2.521 p < 0.001) were significantly associated with an increased risk of progression. Addition of the BMI to a model that included standard clinicopathological factors increased the C-index by 1.9.The BMI could have a relevant role in the clinical management of T1G3 NMIBC, if associated with bladder cancer recurrence and progression. In particular, this anthropometric factor should be taken into account at initial diagnosis and in therapeutic strategy decision making.",
author = "Michele Battaglia and Vincenzo Serretta and Paolo Verze and Estevao Lima and Riccardo Autorino and Matteo Ferro and Riccardo Schiavina and Gennaro Musi and Almeida, {Gilberto L.} and Marco Borghesi and Gabriele Cozzi and Busetto, {Gian Maria} and Vartolomei, {Mihai Dorin} and Antonio Cioffi and Nicolae Crisan and Amelia Cimmino and {De Berardinis}, Ettore and Matteo Muto and Rodolfo Hurle and Russo, {Giorgio Ivan} and Giovanni Grimaldi and Farhan, {Abdal Rahman Abu} and Francesco Cantiello and Daniela Terracciano and Sisto Perdon{\`a} and {De Cobelli}, Ottavio and Matei, {Deliu Victor} and Pierluigi Bove and Shahrokh Shariat and {Di Stasi}, Savino and Giuseppe Morgia and Vincenzo Mirone and Giorgio Guazzoni and Rocco Damiano and Michele Battaglia and Giuseppe Lucarelli and Paolo Verze",
year = "2019",
language = "English",
volume = "37",
pages = "507--514",
journal = "World Journal of Urology",
issn = "0724-4983",
publisher = "Springer Verlag",

}

TY - JOUR

T1 - An increased body mass index is associated with a worse prognosis in patients administered BCG immunotherapy for T1 bladder cancer

AU - Battaglia, Michele

AU - Serretta, Vincenzo

AU - Verze, Paolo

AU - Lima, Estevao

AU - Autorino, Riccardo

AU - Ferro, Matteo

AU - Schiavina, Riccardo

AU - Musi, Gennaro

AU - Almeida, Gilberto L.

AU - Borghesi, Marco

AU - Cozzi, Gabriele

AU - Busetto, Gian Maria

AU - Vartolomei, Mihai Dorin

AU - Cioffi, Antonio

AU - Crisan, Nicolae

AU - Cimmino, Amelia

AU - De Berardinis, Ettore

AU - Muto, Matteo

AU - Hurle, Rodolfo

AU - Russo, Giorgio Ivan

AU - Grimaldi, Giovanni

AU - Farhan, Abdal Rahman Abu

AU - Cantiello, Francesco

AU - Terracciano, Daniela

AU - Perdonà, Sisto

AU - De Cobelli, Ottavio

AU - Matei, Deliu Victor

AU - Bove, Pierluigi

AU - Shariat, Shahrokh

AU - Di Stasi, Savino

AU - Morgia, Giuseppe

AU - Mirone, Vincenzo

AU - Guazzoni, Giorgio

AU - Damiano, Rocco

AU - Battaglia, Michele

AU - Lucarelli, Giuseppe

AU - Verze, Paolo

PY - 2019

Y1 - 2019

N2 - The body mass index (BMI) may be associated with an increased incidence and aggressiveness of urological cancers. In this study, we aimed to evaluate the impact of the BMI on survival in patients with T1G3 non-muscle-invasive bladder cancer (NMIBC).A total of 1155 T1G3 NMIBC patients from 13 academic institutions were retrospectively reviewed and patients administered adjuvant intravesical Bacillus Calmette-Gu,rin (BCG) immunotherapy with maintenance were included. Multivariable Cox regression analysis was performed to identify factors predictive of recurrence and progression.After re-TURBT, 288 patients (27.53%) showed residual high-grade NMIBC, while 867 (82.89%) were negative. During follow-up, 678 (64.82%) suffered recurrence, and 303 (30%) progression, 150 (14.34%) died of all causes, and 77 (7.36%) died of bladder cancer. At multivariate analysis, tumor size (hazard ratio [HR]:1.3; p = 0.001), and multifocality (HR:1.24; p = 0.004) were significantly associated with recurrence (c-index for the model:55.98). Overweight (HR: 4; p < 0.001) and obesity (HR:5.33 p < 0.001) were significantly associated with an increased risk of recurrence. Addition of the BMI to a model that included standard clinicopathological factors increased the C-index by 9.9. For progression, we found that tumor size (HR:1.63; p < 0.001), multifocality (HR:1.31; p = 0.01) and concomitant CIS (HR: 2.07; p < 0.001) were significant prognostic factors at multivariate analysis (C-index 63.8). Overweight (HR: 2.52; p < 0.001) and obesity (HR: 2.521 p < 0.001) were significantly associated with an increased risk of progression. Addition of the BMI to a model that included standard clinicopathological factors increased the C-index by 1.9.The BMI could have a relevant role in the clinical management of T1G3 NMIBC, if associated with bladder cancer recurrence and progression. In particular, this anthropometric factor should be taken into account at initial diagnosis and in therapeutic strategy decision making.

AB - The body mass index (BMI) may be associated with an increased incidence and aggressiveness of urological cancers. In this study, we aimed to evaluate the impact of the BMI on survival in patients with T1G3 non-muscle-invasive bladder cancer (NMIBC).A total of 1155 T1G3 NMIBC patients from 13 academic institutions were retrospectively reviewed and patients administered adjuvant intravesical Bacillus Calmette-Gu,rin (BCG) immunotherapy with maintenance were included. Multivariable Cox regression analysis was performed to identify factors predictive of recurrence and progression.After re-TURBT, 288 patients (27.53%) showed residual high-grade NMIBC, while 867 (82.89%) were negative. During follow-up, 678 (64.82%) suffered recurrence, and 303 (30%) progression, 150 (14.34%) died of all causes, and 77 (7.36%) died of bladder cancer. At multivariate analysis, tumor size (hazard ratio [HR]:1.3; p = 0.001), and multifocality (HR:1.24; p = 0.004) were significantly associated with recurrence (c-index for the model:55.98). Overweight (HR: 4; p < 0.001) and obesity (HR:5.33 p < 0.001) were significantly associated with an increased risk of recurrence. Addition of the BMI to a model that included standard clinicopathological factors increased the C-index by 9.9. For progression, we found that tumor size (HR:1.63; p < 0.001), multifocality (HR:1.31; p = 0.01) and concomitant CIS (HR: 2.07; p < 0.001) were significant prognostic factors at multivariate analysis (C-index 63.8). Overweight (HR: 2.52; p < 0.001) and obesity (HR: 2.521 p < 0.001) were significantly associated with an increased risk of progression. Addition of the BMI to a model that included standard clinicopathological factors increased the C-index by 1.9.The BMI could have a relevant role in the clinical management of T1G3 NMIBC, if associated with bladder cancer recurrence and progression. In particular, this anthropometric factor should be taken into account at initial diagnosis and in therapeutic strategy decision making.

UR - http://hdl.handle.net/10447/359468

M3 - Article

VL - 37

SP - 507

EP - 514

JO - World Journal of Urology

JF - World Journal of Urology

SN - 0724-4983

ER -