When is obesity a favorable prognostic factor in renal cell carcinoma (RCC)?

Updated: May 21, 2019
  • Author: Kush Sachdeva, MD; Chief Editor: E Jason Abel, MD  more...
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Answer

In addition, Albiges and colleagues identified obesity as a favorable prognostic factor in patients with metastatic renal cell carcinoma treated with targeted therapy. In a study of 1975 patients from the International Metastatic Renal Cell Carcinoma Database Consortium (IMDC), median overall survival was 25.6 months in patients with a body mass index (BMI) of 25 kg/m2 or higher, compared with 17.1 months in patients with a BMI of less than 25 kg/m2. The adjusted hazard ratio (HR) for obesity was 0.84. [16, 17]

Review of an external validation cohort of 4657 patients treated for kidney cancer in clinical trials from 2003 to 2013 also demonstrated longer overall survival in obese patients, with median overall survivals of 23.4 months versus 14.5 months for those with low BMI. [16, 17]

The longer survival may relate to the fatty acid synthase (FASN) pathway. FASN acts as a metabolic oncogene and its overexpression has been associated with poor prognosis in renal cell carcinoma and other types of cancers. FASN was downregulated in overweight and obese patients in this study.. [16, 17]


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