TY - JOUR
T1 - Effect of Obesity and Overweight Status on Complications and Survival after Minimally Invasive Kidney Surgery in Patients with Clinical T2-4 Renal Masses
T2 - Journal of Endourology
AU - Marchioni, M.
AU - Berardinelli, F.
AU - Zhang, C.
AU - Simone, G.
AU - Uzzo, R.G.
AU - Capitanio, U.
AU - Minervini, A.
AU - Lau, C.
AU - Kaouk, J.
AU - Langenstroer, P.
AU - Amparore, D.
AU - De Luyk, N.
AU - Porter, J.
AU - Gallucci, M.
AU - Kutikov, A.
AU - Larcher, A.
AU - Mari, A.
AU - Kilday, P.
AU - Rha, K.H.
AU - Quarto, G.
AU - Perdonà, S.
AU - White, W.
AU - Eun, D.D.
AU - Derweesh, I.
AU - Mottrie, A.
AU - Anele, U.A.
AU - Jacobsohn, K.
AU - Porpiglia, F.
AU - Challacombe, B.
AU - Sundaram, C.P.
AU - Autorino, R.
AU - Yang, B.
AU - Schips, L.
N1 - Cited By :1
Export Date: 11 March 2021
CODEN: JENDE
Correspondence Address: Marchioni, M.; Department of Medical Oral and Biotechnological Sciences, Via dei Vestini, Italy; email: mic.marchioni@gmail.com
PY - 2020
Y1 - 2020
N2 - Objective: To evaluate the effect of obesity and overweight on surgical, functional, and survival outcomes in patients with large kidney masses after minimally invasive surgery. Materials and Methods: Within a multicenter multinational dataset, patients found to have ≥cT2 renal mass and treated with minimally invasive (laparoscopic or robotic) kidney surgery (radical or partial nephrectomy) during the period 2003 to 2017 were abstracted. They were stratified according to the body mass index classes as normal weight (18.5-24.9 kg/m2), overweight (25.0-29.9 kg/m2), and obese (≥30.0 kg/m2). Mixed models and Cox proportional hazard regression tested differences in complication rates, estimated glomerular filtration rate (eGFR) change over time, overall mortality (OM), and disease recurrence (DR) rates. Results: Of 812 patients, 30.6% were normal weight, 42.7% were overweight, and 26.7% obese. Overweight (odds ratio 0.82, 95% confidence interval [CI]: 0.51-1.31, p = 0.406) and obese patients (OR: 0.81, 95% CI: 0.44-1.47, p = 0.490) experienced similar complication rates than normal weight. Moreover, no statistically significant differences in eGFR were found for overweight (p = 0.129) or obese (p = 0.166) patients compared to normal weight. However, higher OM rates were recorded in overweight (hazard ratio [HR] 3.59, 95% CI: 1.03-12.51, p = 0.044), as well as in obese, patients (HR 7.83, 95% CI: 2.20-27.83, p = 0.002). Similarly, higher DR rates were recorded in obese (HR 2.76, 95% CI: 1.40-5.44, p = 0.003) patients. Conclusions: Obese and overweight patients do not experience higher complication rates or worse eGFR after minimally invasive kidney surgery, which therefore can be deemed feasible and safe also in this subset of patients. Nevertheless, obese and overweight patients seem to carry a higher risk of OM, and therefore, they should undergo a strict follow-up after surgery. © Copyright 2020, Mary Ann Liebert, Inc.
AB - Objective: To evaluate the effect of obesity and overweight on surgical, functional, and survival outcomes in patients with large kidney masses after minimally invasive surgery. Materials and Methods: Within a multicenter multinational dataset, patients found to have ≥cT2 renal mass and treated with minimally invasive (laparoscopic or robotic) kidney surgery (radical or partial nephrectomy) during the period 2003 to 2017 were abstracted. They were stratified according to the body mass index classes as normal weight (18.5-24.9 kg/m2), overweight (25.0-29.9 kg/m2), and obese (≥30.0 kg/m2). Mixed models and Cox proportional hazard regression tested differences in complication rates, estimated glomerular filtration rate (eGFR) change over time, overall mortality (OM), and disease recurrence (DR) rates. Results: Of 812 patients, 30.6% were normal weight, 42.7% were overweight, and 26.7% obese. Overweight (odds ratio 0.82, 95% confidence interval [CI]: 0.51-1.31, p = 0.406) and obese patients (OR: 0.81, 95% CI: 0.44-1.47, p = 0.490) experienced similar complication rates than normal weight. Moreover, no statistically significant differences in eGFR were found for overweight (p = 0.129) or obese (p = 0.166) patients compared to normal weight. However, higher OM rates were recorded in overweight (hazard ratio [HR] 3.59, 95% CI: 1.03-12.51, p = 0.044), as well as in obese, patients (HR 7.83, 95% CI: 2.20-27.83, p = 0.002). Similarly, higher DR rates were recorded in obese (HR 2.76, 95% CI: 1.40-5.44, p = 0.003) patients. Conclusions: Obese and overweight patients do not experience higher complication rates or worse eGFR after minimally invasive kidney surgery, which therefore can be deemed feasible and safe also in this subset of patients. Nevertheless, obese and overweight patients seem to carry a higher risk of OM, and therefore, they should undergo a strict follow-up after surgery. © Copyright 2020, Mary Ann Liebert, Inc.
KW - kidney cancer
KW - large renal masses
KW - minimally invasive kidney surgery
KW - robotic kidney surgery
KW - robotic partial nephrectomy
KW - adult
KW - aged
KW - Article
KW - body mass
KW - body weight
KW - cancer surgery
KW - cancer survival
KW - clinical outcome
KW - controlled study
KW - data base
KW - estimated glomerular filtration rate
KW - female
KW - health status
KW - human
KW - human tissue
KW - kidney surgery
KW - kidney tumor
KW - laparoscopic surgery
KW - major clinical study
KW - male
KW - minimally invasive surgery
KW - mortality
KW - obesity
KW - outcome assessment
KW - partial nephrectomy
KW - postoperative complication
KW - priority journal
KW - proportional hazards model
KW - radical nephrectomy
KW - recurrence risk
KW - recurrent disease
KW - robot assisted surgery
KW - surgical patient
U2 - 10.1089/end.2019.0604
DO - 10.1089/end.2019.0604
M3 - Article
VL - 34
SP - 289
EP - 297
JO - J. Endourol.
JF - J. Endourol.
SN - 0892-7790
IS - 3
ER -