• Nicholas M Donin, Allan Pantuck, Pia Klöpfer, Paul Bevan, Barbara Fall, Jonathan Said, Arie S Belldegrun, and Karim Chamie.
• Department of Urology, David Geffen School of Medicine, University of California, Los Angeles, California.
• Cancer Epidemiol. Biomarkers Prev. 2016 Sep 1; 25 (9): 1326-32.

BackgroundThe relationship between adiposity and renal cell carcinoma is poorly understood. Prior studies have suggested body mass index (BMI) may be associated with indolent disease.MethodsWe reviewed the clinicopathologic records of 845 patients across 14 countries who were enrolled in a prospective, placebo-controlled study of adjuvant girentuximab treatment for high-risk renal cell carcinoma. Clinical features analyzed included age, gender, race, BMI, and performance status. BMI was stratified into <25 kg/m(2), 25.0-29.9 kg/m(2), 30.0-34.9 kg/m(2), and ≥35 kg/m(2) We examined the association of BMI with stage and survival using logistic and Cox regression analyses, respectively.Results845 patients were included for analysis. The majority (72%) were overweight/obese. There was an inverse relationship between BMI and lymph node involvement (P = 0.04). Obesity was associated with improved disease-free and overall survival (log rank <0.01 for both). When compared with normal weight subjects, those with a BMI 30-34.9 [HR 0.50; 95% confidence interval (CI) 0.31-0.81] and BMI ≥35 (HR 0.24; 95% CI 0.09-0.60) had significantly improved overall survival. A trend towards improved disease-free survival was found among subjects with BMI 30-34.9 (HR 0.77; 95% CI 0.56-1.05) and ≥35 (HR 0.74; 95% CI, 0.48-1.15).ConclusionsIn a prospective cohort of nephrectomized patients with high-risk disease, obesity is associated with lower risk of lymphatic spread and improved overall survival.ImpactThis is the first study utilizing data from a prospective randomized trial reporting an association between obesity and improved overall survival for patients with clear cell renal cell carcinoma. Cancer Epidemiol Biomarkers Prev; 25(9); 1326-32. ©2016 AACR.©2016 American Association for Cancer Research.

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