Does Body Mass Index Affect Outcome After Reconstruction of Orthotopic Neobladder?

Reyes, Martha; Nieder, Alan M.; Kava, Bruce R.; Soloway, Mark S.; Manoharan, Murugesan

doi:10.1016/j.urology.2006.11.012

Cited by 23 publications

(17 citation statements)

References 18 publications

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“…In addition, an increased incidence of urinary tract infection, pyelonephritis and wound infection was found after radical cystectomy in patients with increased BMI. These complications were transient and not life threatening [12] . The tumor biology differences of why obese BMI exerts worse clinical outcome in certain other cancer types like colon, breast and esophagus carcinoma, but not in bladder cancer, is unclear and should be the main focus of further studies in this field [8] .…”

Section: Discussionmentioning

confidence: 84%

Preoperative Hydronephrosis Predicts Advanced Bladder Cancer but Is Not an Independent Factor for Cancer-Specific Survival after Radical Cystectomy

Höfner

Haferkamp²,

Knapp³

et al. 2010

Urol Int

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Introduction: Hydronephrosis and BMI are analyzed together with established factors such as TNM stage and surgical margins in a multivariate modality to investigate their status as independent prognostic factors for bladder cancer-specific survival in patients undergoing radical cystectomy. Patients and Methods: We studied a prospective cohort of 328 patients who underwent radical cystectomy for bladder cancer at our institution. Statistical analyses were performed using the Kaplan-Meier method, Kendall-tau rank correlation and multivariate Cox proportional hazard model. Results: Hydronephrosis was positively correlated with advanced tumor stage, positive lymph node involvement and positive surgical margins. Adjusted for all other investigated parameters, BMI and hydronephrosis did not affect cancer-specific survival. In multivariate analysis only non-organ-confined disease (HR: 1.40, 95% CI: 1.04–1.87, p = 0.024), positive lymph node stage (HR 1.71: 95% CI: 1.12–2.61, p = 0.013) and positive surgical margins (HR 3.00, 95% CI: 1.74–5.15, p < 0.001) were prognostic factors. Conclusions: Hydronephrosis at the time of radical cystectomy is significantly correlated with the presence of more advanced bladder cancer and positive surgical margins. However, the long-established parameters pT stage, pN stage and surgical margins predominantly influence cancer-specific survival for patients undergoing radical cystectomy irrespective of hydronephrosis and BMI status.

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Section: Discussionmentioning

confidence: 84%

Preoperative Hydronephrosis Predicts Advanced Bladder Cancer but Is Not an Independent Factor for Cancer-Specific Survival after Radical Cystectomy

Höfner

Haferkamp²,

Knapp³

et al. 2010

Urol Int

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“…It is, therefore, important that all patients who undergo NB possess the skills and the ability to catheterize. Elevated body mass index is not a contraindication for NB [17,18] . Age is not a contraindication for a NB as long as they possess the motor and intellectual skills and the ability to understand how to properly catheterize [19] .…”

Section: Discussionmentioning

confidence: 97%

Role of Patient-Physician Dialogue in Selecting the Type of Urinary Diversion

et al. 2010

Self Cite

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Introduction: We analyze patient-physician dialogue prior to radical cystectomy (RC) when choosing the type of urinary diversion (UD). Methods: 132 patients operated by one surgical team between 2003 and 2005 were included. Physician’s recommendation, patient’s decision and UD (neobladder (NB) or ileal conduit (IC)) performed were analyzed. Patients were grouped based on age, considering that age is often a limiting factor for NB. Results: When offered either NB or IC, 85% (49/58) in group I (<70 years) and 55% (12/22) in group II (≧70 years) elected NB. An IC was suggested for 16% (11/69) in group I and 65% (41/63) in group II. Six patients (2 in group I, 4 in group II) wanted a NB even though an IC was suggested. Conclusions: Counseling patients is important. When an IC was suggested, over 80% accepted this advice. When both were offered, younger patients usually elected a NB. Older patients preferred an IC.

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“…Twelve studies investigated the association between BMI and RC outcomes [33][34][35][36][37][38][39][40][41][42][43][44] . Reyes et al 33 found that tract infections, pyelonephritis, wound infections and overall complications were less frequent in normal-weight patients (18.5-24.9kg/m 2 ) compared to overweight (25-29.9kg/m 2 ) and obese (≥30.0kg/m 2 ) patients.…”

Section: Body Mass Indexmentioning

confidence: 99%

“…Reyes et al 33 found that tract infections, pyelonephritis, wound infections and overall complications were less frequent in normal-weight patients (18.5-24.9kg/m 2 ) compared to overweight (25-29.9kg/m 2 ) and obese (≥30.0kg/m 2 ) patients. BMI was not a predictor of mortality and complication development after RC in the Maurer et al 35 study, except for postoperative bleeding, which was more frequent in subjects with a high BMI.…”

Section: Body Mass Indexmentioning

confidence: 99%

Preoperative nutritional factors and outcomes after radical cystectomy: A narrative review

Allaire

Ben-Zvi

Lamarche

et al. 2017

CUAJ

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Only a few nutritional factors have been identified to predict the risk of developing complications after radical cystectomy (RC). This narrative review delineates the current known effects of preoperative nutritional status factors in this context. The report highlighted the heterogeneity between study methods and results. We determined that low albuminemia values increase mortality risk and overall complications. In addition, obesity tends to increase the risk of developing venous thromboembolism and adverse events. Additional prospective studies, using standardized methods to both define and report complications, should be conducted to strengthen the connections between preoperative nutritional status factors and post-RC complications. Furthermore, intervention studies testing the impact of strategies to improve nutritional status on the risk of complications after RC are also needed.

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Does Body Mass Index Affect Outcome After Reconstruction of Orthotopic Neobladder?

Cited by 23 publications

References 18 publications

Preoperative Hydronephrosis Predicts Advanced Bladder Cancer but Is Not an Independent Factor for Cancer-Specific Survival after Radical Cystectomy

Preoperative Hydronephrosis Predicts Advanced Bladder Cancer but Is Not an Independent Factor for Cancer-Specific Survival after Radical Cystectomy

Role of Patient-Physician Dialogue in Selecting the Type of Urinary Diversion

Preoperative nutritional factors and outcomes after radical cystectomy: A narrative review

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