Body mass index at diagnosis, postdiagnosis change, and role of metabolic comorbidities in relation to survival in nonmetastatic renal cell carcinoma patients.
18 affiliations
- 1Department of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Buffalo, New York, USA.
- 2Department of Urology, Stanford University School of Medicine, Stanford, California, USA.
- 3Department of Epidemiology, Stanford University, Palo Alto, California, USA.
- 4Department of Urology, Roswell Park Comprehensive Cancer Center, Buffalo, New York, USA.
- 5Division of Research, Kaiser Permanente Northern California, Pleasanton, California, USA.
- 6Huntsman Cancer Institute, Salt Lake City, Utah, USA.
- 7H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida, USA.
- 8Department of Urology, Ohio State University, Columbus, Ohio, USA.
- 9University of Iowa, Holden Comprehensive Cancer Center, Iowa City, Iowa, USA.
- 10Division of Hematology/Oncology, University of Virginia Comprehensive Cancer Center, Charlottesville, Virginia, USA.
- 11University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA.
- 12Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey, USA.
- 13Norris Comprehensive Cancer Center and Keck School of Medicine of the University of Southern California, Los Angeles, California, USA.
- 14Murtha Cancer Center, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA.
- 15Stephenson Cancer Center, University of Oklahoma, Oklahoma City, Oklahoma, USA.
- 16Markey Cancer Center, University of Kentucky, Lexington, Kentucky, USA.
- 17Indiana University Simon Comprehensive Cancer Center, Indianapolis, Indiana, USA.
- 18Aster Insights, Tampa, Florida, USA.
Abstract
Background
Obesity is a recognized risk factor for renal cell carcinoma (RCC) incidence, but higher body mass index (BMI) measured at diagnosis has been paradoxically associated with improved survival. This study investigated whether postdiagnosis changes in BMI and metabolic comorbidities combined with BMI at diagnosis are associated with survival.Methods
This study examined 1289 patients with nonmetastatic RCC (stage I-III) from the Oncology Research Information Exchange Network. BMI was assessed at diagnosis and at 2 and 3 years postdiagnosis. Multivariable Cox regression and restricted cubic spline models estimated hazard ratios (HRs) for overall survival (OS) and disease-free survival (DFS).Results
Modest weight gain (<10%) and stability were most favorable trajectories. Compared with modest weight gain, postdiagnosis weight loss was associated with worse OS and DFS (>10% loss at 2 years: OS HR, 7.77; 95% CI, 3.00-20.16; DFS HR, 3.13; 95% CI, 1.68-5.82), independent of BMI at diagnosis, whereas substantial weight gain was associated with worse OS (>10% gain at 3 years: OS HR, 3.26; 95% CI, 1.14-9.32). Nonobese patients with diabetes had significantly worse DFS (HR, 1.83; 95% CI, 1.22-2.76), whereas the association between obesity and improved survival was mainly limited to patients without diabetes (HR, 0.75; 95% CI, 0.58-0.97).Conclusions
Postdiagnosis weight trajectory and metabolic health are important prognostic factors for nonmetastatic RCC. Weight stability and absence of diabetes were associated with more favorable outcomes. Incorporating repeated BMI measurements and diabetes status may improve risk stratification during RCC survivorship.
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BibTeX
@article{sarker2026body,
title = {{Body mass index at diagnosis, postdiagnosis change, and role of metabolic comorbidities in relation to survival in nonmetastatic renal cell carcinoma patients.}},
author = {Monica Sarker and Zhengyi Deng and Eric C Kauffman and Li Tang and Marilyn L Kwan and Marvin E Langston and Sumati Gupta and G Daniel Grass and Eric A Singer and Yousef Zakharia and Paul V Viscuse and Laura Graham and Saum Ghodoussipour and Bodour Salhia and Sean Q Kern and Adanma Ayanambakkam and Zin Myint and Jennifer King and Seyi Oderinde and Michelle L Churchman and Robert J Rounbehler and Ken Batai},
journal = {Cancer},
year = {2026},
month = oct,
doi = {10.1002/cncr.70653},
url = {https://europepmc.org/article/MED/42913421},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Body mass index at diagnosis, postdiagnosis change, and role of metabolic comorbidities in relation to survival in nonmetastatic renal cell carcinoma patients.
AU - Monica Sarker
AU - Zhengyi Deng
AU - Eric C Kauffman
AU - Li Tang
AU - Marilyn L Kwan
AU - Marvin E Langston
AU - Sumati Gupta
AU - G Daniel Grass
AU - Eric A Singer
AU - Yousef Zakharia
AU - Paul V Viscuse
AU - Laura Graham
AU - Saum Ghodoussipour
AU - Bodour Salhia
AU - Sean Q Kern
AU - Adanma Ayanambakkam
AU - Zin Myint
AU - Jennifer King
AU - Seyi Oderinde
AU - Michelle L Churchman
AU - Robert J Rounbehler
AU - Ken Batai
PY - 2026
DA - 2026/10/30
JO - Cancer
DO - 10.1002/cncr.70653
UR - https://europepmc.org/article/MED/42913421
AB - Background Obesity is a recognized risk factor for renal cell carcinoma (RCC) incidence, but higher body mass index (BMI) measured at diagnosis has been paradoxically associated with improved survival. This study investigated whether postdiagnosis changes in BMI and metabolic comorbidities combined with BMI at diagnosis are associated with survival.Methods This study examined 1289 patients with nonmetastatic RCC (stage I-III) from the Oncology Research Information Exchange Network. BMI was assessed at diagnosis and at 2 and 3 years postdiagnosis. Multivariable Cox regression and restricted cubic spline models estimated hazard ratios (HRs) for overall survival (OS) and disease-free survival (DFS).Results Modest weight gain (<10%) and stability were most favorable trajectories. Compared with modest weight gain, postdiagnosis weight loss was associated with worse OS and DFS (>10% loss at 2 years: OS HR, 7.77; 95% CI, 3.00-20.16; DFS HR, 3.13; 95% CI, 1.68-5.82), independent of BMI at diagnosis, whereas substantial weight gain was associated with worse OS (>10% gain at 3 years: OS HR, 3.26; 95% CI, 1.14-9.32). Nonobese patients with diabetes had significantly worse DFS (HR, 1.83; 95% CI, 1.22-2.76), whereas the association between obesity and improved survival was mainly limited to patients without diabetes (HR, 0.75; 95% CI, 0.58-0.97).Conclusions Postdiagnosis weight trajectory and metabolic health are important prognostic factors for nonmetastatic RCC. Weight stability and absence of diabetes were associated with more favorable outcomes. Incorporating repeated BMI measurements and diabetes status may improve risk stratification during RCC survivorship.
SN - 0008-543X
SN - 1097-0142
ER -