Skip to main content

Advertisement

SpringerLink
Log in

Obesity is associated with improved survival in patients with organ-confined clear-cell kidney cancer

  • Original paper
  • Published:
Cancer Causes & Control Aims and scope Submit manuscript

Abstract

Objectives

Obesity increases the risk of developing renal cell carcinoma (RCC); however, it remains unclear whether obesity is associated with RCC aggressiveness and survival. We assessed whether different body mass index (BMI) levels at the time of surgery had an effect on long-term prognosis of RCC patients.

Methods

We evaluated 1,338 clear-cell RCC patients with complete information about their BMI, who had undergone surgery for renal cell cancer at the University Hospitals in Hannover and Marburg between 1991 and 2005. The mean follow-up was 5.1 years.

Results

Underweight, normal weight, pre-obesity, and obesity were diagnosed in 14 (1.0%), 444 (33.2%), 593 (44.3%), and 287 (21.4%) RCC patients, respectively. A lower BMI was significantly associated with higher age, tumor grade, and the rate of metastasis at diagnosis. Overweight patients had a significantly lower risk of cancer-related death; their median 5-year tumor-specific survival rate was 70.9% (pre-obese), 74.0% (obese grad I), and 85.6% (obese grad ≥II) as opposed to 63.8% for patients with a BMI below 25 (p < 0.001). Interestingly, subgroup analysis revealed that the positive association between overweight and survival was found in organ-confined RCC only.

Conclusion

We identified overweight as an independent prognostic marker of improved cancer specific survival in patients with organ-confined but not advanced RCC. Basic research is required to resolve the dilemma of why, if a higher BMI predisposes to RCC, it concurrently prolongs survival after patients have undergone (partial) nephrectomy.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

Similar content being viewed by others

References

  1. GEKID (2008) Cancer in Germany—incidence and trends, vol 6. Robert Koch Institute, pp 78–81 (www.gekid.de)

  2. Hu J, La Vecchia C, Negri E, Desmeules M, Mery L (2009) Dietary vitamin C, E, and carotenoid intake and risk of renal cell carcinoma. Cancer Causes Control 20:1451–1458

    Article  PubMed  Google Scholar 

  3. Wolk A, Gridley G, Niwa S, Lindblad P, McCredie M, Mellemgaard A, Mandel JS, Wahrendorf J, McLaughlin JK, Adami HO (1996) International renal cell cancer study. VII. Role of diet. Int J Cancer 65:67–73

    Article  CAS  PubMed  Google Scholar 

  4. Wolk A, Lindblad P, Adami HO (1996) Nutrition and renal cell cancer. Cancer Causes Control 7:5–18

    Article  CAS  PubMed  Google Scholar 

  5. Moyad MA (2001) Obesity, interrelated mechanisms, and exposures and kidney cancer. Semin Urol Oncol 19:270–279

    CAS  PubMed  Google Scholar 

  6. Chow WH, Gridley G, Fraumeni JF Jr, Jarvholm B (2000) Obesity, hypertension, and the risk of kidney cancer in men. N Engl J Med 343:1305–1311

    Article  CAS  PubMed  Google Scholar 

  7. Asal NR, Risser DR, Kadamani S, Geyer JR, Lee ET, Cherng N (1988) Risk factors in renal cell carcinoma: I. Methodology, demographics, tobacco, beverage use, and obesity. Cancer Detect Prev 11:359–377

    CAS  PubMed  Google Scholar 

  8. Calle EE, Rodriguez C, Walker-Thurmond K, Thun MJ (2003) Overweight, obesity, and mortality from cancer in a prospectively studied cohort of U.S. adults. N Engl J Med 348:1625–1638

    Article  PubMed  Google Scholar 

  9. Samanic C, Chow WH, Gridley G, Jarvholm B, Fraumeni JF Jr (2006) Relation of body mass index to cancer risk in 362,552 Swedish men. Cancer Causes Control 17:901–909

    Article  PubMed  Google Scholar 

  10. Kamat AM, Shock RP, Naya Y, Rosser CJ, Slaton JW, Pisters LL (2004) Prognostic value of body mass index in patients undergoing nephrectomy for localized renal tumors. Urology 63:46–50

    Article  PubMed  Google Scholar 

  11. Yu ML, Asal NR, Geyer JR (1991) Later recurrence and longer survival among obese patients with renal cell carcinoma. Cancer 68:1648–1655

    Article  CAS  PubMed  Google Scholar 

  12. Schips L, Lipsky K, Zigeuner R, Gidaro S, Salfellner M, Rehak P, Pummer K, Hubmer G (2004) Does overweight impact on the prognosis of patients with renal cell carcinoma? A single center experience of 683 patients. J Surg Oncol 88:57–61

    Article  PubMed  Google Scholar 

  13. Donat SM, Salzhauer EW, Mitra N, Yanke BV, Snyder ME, Russo P (2006) Impact of body mass index on survival of patients with surgically treated renal cell carcinoma. J Urol 175:46–52

    Article  PubMed  Google Scholar 

  14. Parker AS, Lohse CM, Cheville JC, Thiel DD, Leibovich BC, Blute ML (2006) Greater body mass index is associated with better pathologic features and improved outcome among patients treated surgically for clear cell renal cell carcinoma. Urology 68:741–746

    Article  PubMed  Google Scholar 

  15. Haferkamp A, Pritsch M, Bedke J, Wagener N, Pfitzenmaier J, Buse S, Hohenfellner M (2008) The influence of body mass index on the long-term survival of patients with renal cell carcinoma after tumour nephrectomy. BJU Int 101:1243–1246

    Article  PubMed  Google Scholar 

  16. Dhote R, Thiounn N, Debre B, Vidal-Trecan G (2004) Risk factors for adult renal cell carcinoma. Urol Clin North Am 31:237–247

    Article  CAS  PubMed  Google Scholar 

  17. Wolk A, Gridley G, Svensson M, Nyren O, McLaughlin JK, Fraumeni JF, Adam HO (2001) A prospective study of obesity and cancer risk (Sweden). Cancer Causes Control 12:13–21

    Article  CAS  PubMed  Google Scholar 

  18. Pan SY, Johnson KC, Ugnat AM, Wen SW, Mao Y (2004) Association of obesity and cancer risk in Canada. Am J Epidemiol 159:259–268

    Article  PubMed  Google Scholar 

  19. Lowrance WT, Thompson RH, Yee DS, Kaag M, Donat SM, Russo P (2009) Obesity is associated with a higher risk of clear-cell renal cell carcinoma than with other histologies. BJU Int 105:16–20

    Article  PubMed  Google Scholar 

  20. Schrader AJ, Rustemeier J, Rustemeier JC, Timmesfeld N, Varga Z, Hegele A, Olbert PJ, Hofmann R (2009) Overweight is associated with improved cancer-specific survival in patients with organ-confined renal cell carcinoma. J Cancer Res Clin Oncol 135:1693–1699

    Article  PubMed  Google Scholar 

  21. Flanigan RC, Mickisch G, Sylvester R, Tangen C, Van Poppel H, Crawford ED (2004) Cytoreductive nephrectomy in patients with metastatic renal cancer: a combined analysis. J Urol 171:1071–1076

    Article  PubMed  Google Scholar 

  22. Kirkali Z (2007) The motion: open partial nephrectomy is the standard of care for small resectable solid renal masses. Eur Urol 51:561–562

    Article  PubMed  Google Scholar 

  23. Yu MC, Mack TM, Hanisch R, Cicioni C, Henderson BE (1986) Cigarette smoking, obesity, diuretic use, and coffee consumption as risk factors for renal cell carcinoma. J Natl Cancer Inst 77:351–356

    CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Urology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany

    Sandra Waalkes, Axel S. Merseburger, Mario W. Kramer, Thomas R. W. Herrmann, Gerd Wegener & Markus A. Kuczyk

  2. Department of Urology, Philipps-University Medical School, Baldingerstrasse, 35043, Marburg, Germany

    Julia Rustemeier, Rainer Hofmann & Andres J. Schrader

  3. Department of Urology, Ulm-University Medical School, Prittwitzstrasse 43, 89075, Ulm, Germany

    Mark Schrader & Andres J. Schrader

Authors
  1. Sandra Waalkes
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Axel S. Merseburger
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Mario W. Kramer
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Thomas R. W. Herrmann
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Gerd Wegener
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Julia Rustemeier
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Rainer Hofmann
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Mark Schrader
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Markus A. Kuczyk
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Andres J. Schrader
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Andres J. Schrader.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Waalkes, S., Merseburger, A.S., Kramer, M.W. et al. Obesity is associated with improved survival in patients with organ-confined clear-cell kidney cancer. Cancer Causes Control 21, 1905–1910 (2010). https://doi.org/10.1007/s10552-010-9618-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10552-010-9618-2

Keywords

Search

Navigation