The Effect of Body Mass Index on Oncological and Surgical Outcomes in
Patients Undergoing Radical Cystectomy for Bladder Cancer: A Multicenter
Study of the Association of Urooncology, Turkey
Abstract
Objective: We aimed to evaluate the effect of body mass index (BMI) on
oncological and surgical outcomes in patients who underwent radical
cystectomy (RC) for bladder cancer (BC). Materials and Methods We
retrospectively assessed data from patients who underwent RC with pelvic
lymphadenectomy and urinary diversion for BC recorded in the bladder
cancer database of the Urooncology Association, Turkey between 2007 and
2019. Patients were stratified into three groups according to the BMI
cut-off values recommended by the WHO; Group 1 (normal weight,
<25 kg/m2), Group 2 (overweight, 25.0–29.9 kg/m2) and Group 3
(obese, ≥30 kg/m2) Results In all, 494 patients were included, of them
429 (86.8%) were male and 65 (13.2%) were female. The median follow-up
was 24 months (12-132 months). At the time of surgery, the number of
patients in groups 1, 2 and 3 were 202 (40.9%), 215 (43.5%) and 77
(15.6%), respectively. The mean operation time and time to
postoperative oral feeding were longer and major complications were
statistically higher in Group 3 compared to Groups 1 and 2 (p=0.019,
p<0.001 and p=0.025 respectively). Although the mean overall
survival (OS), cancer-specific survival (CSS), recurrence-free survival
(RFS) and metastasis-free survival (MFS) was shorter in cases with BMI
≥30 kg/m2 compared with other BMI groups, differences were not
statistically significant (p=0.532, p=0.309, p=0.751 and p=0.213
respectively). Conclusion Our study showed that, although major
complications are more common in obese patients, the increase in BMI
does not reveal a significant negative effect on OS, CSS, RFS, and MFS.