Impact of body mass index on radical cystectomy

The Journal of Urology
Cheryl LeeJames E Montie

Abstract

Radical cystectomy has a significant rate of morbidity and it is important to elucidate the factors that contribute to this risk. Obesity is a major problem in the United States and is associated with increased health hazard. Morbid obesity may even preclude definitive surgical treatment. This study examines the impact of body mass index (BMI) on radical cystectomy. Retrospective analysis was performed on 498 patients who underwent radical cystectomy primarily for bladder cancer from July 1, 1990 to May 10, 2002. Patient BMI was defined as normal (less than 25 in 151), overweight (25 to 29.9 in 198), obese (30 to 34.9 in 98) and morbidly obese (35 or greater in 51). The bivariate relationships among BMI categories and clinical parameters were assessed using the chi-square test, the analysis of variance and the log rank test. Multivariate analyses were performed using Cox regression models. Median followup for the cohort was 3.3 years. Mean BMI was 28 and 70 of the study group was above normal weight. Compared to normal BMI, upper weight BMI groups were younger (p <0.0001), and had increased estimated blood loss (p = 0.01) and operative time (p = 0.001). Complication number (p = 0.0004) was increased in these groups but complica...Continue Reading

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