An epidemiologic and genomic investigation into the obesity paradox in renal cell carcinoma.

Details

Serval ID
serval:BIB_4DCBB01253FE
Type
Article: article from journal or magazin.
Collection
Publications
Title
An epidemiologic and genomic investigation into the obesity paradox in renal cell carcinoma.
Journal
Journal of the National Cancer Institute
Author(s)
Hakimi A.A., Furberg H., Zabor E.C., Jacobsen A., Schultz N., Ciriello G., Mikklineni N., Fiegoli B., Kim P.H., Voss M.H., Shen H., Laird P.W., Sander C., Reuter V.E., Motzer R.J., Hsieh J.J., Russo P.
ISSN
1460-2105 (Electronic)
ISSN-L
0027-8874
Publication state
Published
Issued date
18/12/2013
Peer-reviewed
Oui
Volume
105
Number
24
Pages
1862-1870
Language
english
Notes
Publication types: Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Abstract
Obesity increases risk for clear-cell renal cell carcinoma (ccRCC), yet obese patients appear to experience longer survival than nonobese patients. We examined body mass index (BMI) in relation to stage, grade, and cancer-specific mortality (CSM) while considering detection bias, nutritional status, and molecular tumor features.
Data were available from 2119 ccRCC patients who underwent renal mass surgery at Memorial Sloan-Kettering Cancer Center between 1995 and 2012. Logistic regression models produced associations between BMI and advanced disease. Multivariable competing risks regression models estimated associations between BMI and CSM. Somatic mutation, copy number, methylation, and expression data were examined by BMI among a subset of 126 patients who participated in the Cancer Genome Atlas Project for ccRCC using the Kruskal-Wallis or Fisher exact tests. All statistical tests were two-sided.
Obese and overweight patients were less likely to present with advanced-stage disease compared with normal-weight patients (odds ratio [OR] = 0.61, 95% confidence interval [CI] = 0.48 to 0.79 vs OR = 0.65, 95% CI = 0.51 to 0.83, respectively). Higher BMI was associated with reduced CSM in univariable analyses (P < .005). It remained statistically significant after adjustment for comorbidities and albumin level, but it became non-statistically significant after adjusting for stage and grade (P > .10). Genome-wide interrogation by BMI suggested differences in gene expression of metabolic and fatty acid genes, including fatty acid synthase (FASN), consistent with the obesity paradox.
Our findings suggest that although BMI is not an independent prognostic factor for CSM after controlling for stage and grade, tumors developing in an obesogenic environment may be more indolent.
Keywords
Adult, Aged, Body Mass Index, Carcinoma, Renal Cell/epidemiology, Carcinoma, Renal Cell/etiology, Carcinoma, Renal Cell/genetics, Carcinoma, Renal Cell/mortality, Carcinoma, Renal Cell/pathology, DNA Copy Number Variations, DNA Methylation, Female, Follow-Up Studies, Gene Expression Regulation, Neoplastic, Humans, Kidney Neoplasms/epidemiology, Kidney Neoplasms/etiology, Kidney Neoplasms/genetics, Kidney Neoplasms/mortality, Kidney Neoplasms/pathology, Logistic Models, Male, Medical Records, Middle Aged, Mutation, Neoplasm Grading, Neoplasm Staging, New York City/epidemiology, Obesity/complications, Obesity/epidemiology, Obesity/genetics, Odds Ratio, Overweight/complications, Retrospective Studies, Risk Factors, Survival Analysis
Pubmed
Web of science
Open Access
Yes
Create date
06/07/2018 11:02
Last modification date
20/08/2019 14:02
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