(1) Objective: The aim of this study was to evaluate whether overweight and obese upper urinary tract carcinoma (UTUC) patients have better or worse survival outcomes. (2) Methods: The Clinical Research Office of the Endourology Society Urothelial Carcinomas of the Upper Tract (CROES-UTUC) Registry was used to extract the data of normal-weight or overweight/obese UTUC patients between 2014 and 2019. Patients with a BMI between 18.5 and 24.9 kg/m2were defined as normal weight, while those with a BMI ≥ 25.0 kg/m2were considered as overweight/obese group. We compared baseline characteristics among groups categorized by different BMIs. The Kaplan–Meier plots with the log-rank test were used to explore the overall survival (OS), cancer-specific survival (CSS), and recurrence-free survival (RFS). Propensity score matching was performed to eliminate the differences in clinicopathologic features. The Declaration of Helsinki was followed during this study. (3) Results: Of 1196 UTUC patients, 486 patients (40.6%) were normal weight, while 710 patients (59.4%) presented with a BMI ≥ 25.0 kg/m2. After propensity score matching, all baseline characteristics were balanced. For normal weight and overweight/obese patients, 2-year overall survival rates were 77.8% and 87.2%, 2-year cancer-specific survival rates were 85.2% and 92.7%, and 2-year recurrence rates were 50.6% and 73.0%, respectively. The overweight patients obtained a better RFS (p= 0.003, HR 0.548, 95% CI 0.368–0.916) while their OS (p= 0.373, HR 0.761, 95% CI 0.416–1.390) and CSS (p= 0.272, HR 0.640, 95% CI 0.287–1.427) were similar to normal weight patients. (4) Conclusions: Being overweight/obese (BMI ≥ 25.0 kg/m2) was associated with a decreased risk of recurrence in UTUC patients but not overall survival or cancer-specific survival.
（1）目的：本研究旨在评估超重及肥胖的上尿路尿路上皮癌（UTUC）患者是否具有更好或更差的生存结局。（2）方法：研究数据来源于国际腔内泌尿外科学会上尿路尿路上皮癌临床研究办公室（CROES-UTUC）登记系统，提取2014年至2019年间正常体重或超重/肥胖的UTUC患者资料。体重指数（BMI）在18.5至24.9 kg/m²之间定义为正常体重组，BMI ≥ 25.0 kg/m²定义为超重/肥胖组。比较不同BMI分组间的基线特征，采用Kaplan-Meier曲线与对数秩检验分析总生存期（OS）、癌症特异性生存期（CSS）及无复发生存期（RFS）。通过倾向性评分匹配平衡组间临床病理特征差异。本研究遵循《赫尔辛基宣言》。（3）结果：在1196例UTUC患者中，正常体重组486例（40.6%），超重/肥胖组710例（59.4%）。倾向性评分匹配后所有基线特征均达到平衡。正常体重组与超重/肥胖组的2年总生存率分别为77.8%和87.2%，2年癌症特异性生存率分别为85.2%和92.7%，2年无复发生存率分别为50.6%和73.0%。超重/肥胖组患者表现出更优的无复发生存期（p=0.003，HR 0.548，95% CI 0.368-0.916），而其总生存期（p=0.373，HR 0.761，95% CI 0.416-1.390）和癌症特异性生存期（p=0.272，HR 0.640，95% CI 0.287-1.427）与正常体重组无显著差异。（4）结论：超重/肥胖状态（BMI ≥ 25.0 kg/m²）与UTUC患者复发风险降低相关，但与总生存期及癌症特异性生存期无显著关联。
The Prognostic Role of Body Mass Index on Oncological Outcomes of Upper Tract Urothelial Carcinoma
肿瘤(癌症)患者之家