Body mass index and waist circumference in relation to risk of recurrence and progression after non‐muscle invasive bladder cancer

Abstract Background Obesity may be associated with increased risk of recurrence and progression in patients with non‐muscle invasive bladder cancer (NMIBC), but evidence is limited and inconsistent. We examined the associations of body mass index (BMI), waist circumference, and waist‐to‐hip ratio (W...

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Main Authors: Moniek vanZutphen, Ivy Beeren, Katja K. H. Aben, Antoine G. van derHeijden, J. Alfred Witjes, Lambertus A. L. M. Kiemeney, Alina Vrieling
Format: Article
Language:English
Published: Wiley 2023-10-01
Series:Cancer Medicine
Subjects:
Online Access:https://doi.org/10.1002/cam4.6620
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author Moniek vanZutphen
Ivy Beeren
Katja K. H. Aben
Antoine G. van derHeijden
J. Alfred Witjes
Lambertus A. L. M. Kiemeney
Alina Vrieling
author_facet Moniek vanZutphen
Ivy Beeren
Katja K. H. Aben
Antoine G. van derHeijden
J. Alfred Witjes
Lambertus A. L. M. Kiemeney
Alina Vrieling
author_sort Moniek vanZutphen
collection DOAJ
description Abstract Background Obesity may be associated with increased risk of recurrence and progression in patients with non‐muscle invasive bladder cancer (NMIBC), but evidence is limited and inconsistent. We examined the associations of body mass index (BMI), waist circumference, and waist‐to‐hip ratio (WHR) with risk of recurrence and progression among patients with NMIBC. Methods This prospective study included 1029 patients diagnosed with primary NMIBC between 2014 and 2017. Patients reported weight 2 years before diagnosis at baseline, and weight, waist and hip circumference at 3 months postdiagnosis. Associations were quantified using Cox proportional hazard analyses, adjusted for clinical and lifestyle characteristics. Results More than half of patients were overweight (49%) or obese (19%) after diagnosis. During a median follow‐up time of 3.6 years, 371 patients developed ≥1 recurrence and 53 experienced progression. No associations with recurrence were observed for BMI (HRper 5 kg/m2 0.94; 95% CI 0.82, 1.07), waist circumference (HRper 10 cm 0.95; 95% CI 0.86, 1.05), or WHR (HRper 0.1 unit 0.90; 95% CI 0.76, 1.06). In contrast, higher BMI was associated with a 40% increased risk of progression, with only the 2‐year prediagnosis association reaching statistical significance (HRper 5 kg/m2 1.42; 95% CI 1.09, 1.84). No associations for pre‐to‐postdiagnosis weight change were found. Conclusion General and abdominal obesity were not associated with recurrence risk among patients with NMIBC, but might be associated with increased risk of progression. Studies with sufficient sample size to stratify by tumor stage and treatment are needed to better understand whether and how obesity could influence prognosis.
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spelling doaj.art-85d94436af4b4675bc8d78e2d0721d0c2023-11-16T12:09:00ZengWileyCancer Medicine2045-76342023-10-011220204592046910.1002/cam4.6620Body mass index and waist circumference in relation to risk of recurrence and progression after non‐muscle invasive bladder cancerMoniek vanZutphen0Ivy Beeren1Katja K. H. Aben2Antoine G. van derHeijden3J. Alfred Witjes4Lambertus A. L. M. Kiemeney5Alina Vrieling6Department for Health Evidence Radboud University Medical Center Nijmegen The NetherlandsDepartment for Health Evidence Radboud University Medical Center Nijmegen The NetherlandsDepartment for Health Evidence Radboud University Medical Center Nijmegen The NetherlandsDepartment of Urology Radboud University Medical Center Nijmegen The NetherlandsDepartment of Urology Radboud University Medical Center Nijmegen The NetherlandsDepartment for Health Evidence Radboud University Medical Center Nijmegen The NetherlandsDepartment for Health Evidence Radboud University Medical Center Nijmegen The NetherlandsAbstract Background Obesity may be associated with increased risk of recurrence and progression in patients with non‐muscle invasive bladder cancer (NMIBC), but evidence is limited and inconsistent. We examined the associations of body mass index (BMI), waist circumference, and waist‐to‐hip ratio (WHR) with risk of recurrence and progression among patients with NMIBC. Methods This prospective study included 1029 patients diagnosed with primary NMIBC between 2014 and 2017. Patients reported weight 2 years before diagnosis at baseline, and weight, waist and hip circumference at 3 months postdiagnosis. Associations were quantified using Cox proportional hazard analyses, adjusted for clinical and lifestyle characteristics. Results More than half of patients were overweight (49%) or obese (19%) after diagnosis. During a median follow‐up time of 3.6 years, 371 patients developed ≥1 recurrence and 53 experienced progression. No associations with recurrence were observed for BMI (HRper 5 kg/m2 0.94; 95% CI 0.82, 1.07), waist circumference (HRper 10 cm 0.95; 95% CI 0.86, 1.05), or WHR (HRper 0.1 unit 0.90; 95% CI 0.76, 1.06). In contrast, higher BMI was associated with a 40% increased risk of progression, with only the 2‐year prediagnosis association reaching statistical significance (HRper 5 kg/m2 1.42; 95% CI 1.09, 1.84). No associations for pre‐to‐postdiagnosis weight change were found. Conclusion General and abdominal obesity were not associated with recurrence risk among patients with NMIBC, but might be associated with increased risk of progression. Studies with sufficient sample size to stratify by tumor stage and treatment are needed to better understand whether and how obesity could influence prognosis.https://doi.org/10.1002/cam4.6620abdominalnon‐muscle invasive bladder cancerobesityprogressionrecurrence
spellingShingle Moniek vanZutphen
Ivy Beeren
Katja K. H. Aben
Antoine G. van derHeijden
J. Alfred Witjes
Lambertus A. L. M. Kiemeney
Alina Vrieling
Body mass index and waist circumference in relation to risk of recurrence and progression after non‐muscle invasive bladder cancer
Cancer Medicine
abdominal
non‐muscle invasive bladder cancer
obesity
progression
recurrence
title Body mass index and waist circumference in relation to risk of recurrence and progression after non‐muscle invasive bladder cancer
title_full Body mass index and waist circumference in relation to risk of recurrence and progression after non‐muscle invasive bladder cancer
title_fullStr Body mass index and waist circumference in relation to risk of recurrence and progression after non‐muscle invasive bladder cancer
title_full_unstemmed Body mass index and waist circumference in relation to risk of recurrence and progression after non‐muscle invasive bladder cancer
title_short Body mass index and waist circumference in relation to risk of recurrence and progression after non‐muscle invasive bladder cancer
title_sort body mass index and waist circumference in relation to risk of recurrence and progression after non muscle invasive bladder cancer
topic abdominal
non‐muscle invasive bladder cancer
obesity
progression
recurrence
url https://doi.org/10.1002/cam4.6620
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