Re: Body mass index influences prostate cancer risk at biopsy in Japanese men

Abstract

Re: Body mass index influences prostate cancer risk at biopsy in Japanese menThe recent article by Masuda et al. provided highly interesting reading.1 Body mass index (BMI) might influence the risk of developing other urological cancers, especially renal cell carcinomas (RCC).For instance, in one Korean study, individuals with advanced renal cancer and co-existing obesity showed a better clinical outcome in contrast to patients with lower BMI. Individuals with lower BMI tend to show augmented microvascular invasiveness. Similar higher stages are typically associated with RCC in individuals with low BMI. Similarly, higher Fuhrman grades are typically seen with low BMI.2 A similar positive relationship was noted between recurrence-free survival and BMI. A similar association was seen between the Eastern Cooperative Oncology Group (ECOG) performance status and BMI. For instance, RCC individuals with lower BMI tend to show a worse ECOG performance status. Thus, decreased BMI is in fact an independent parameter associated with decreased cancer-free survival. A similar association is seen between recurrence-free survival and BMI. A similar close relationship has been established in clear cell RCC. For instance, in obese patients with clear cell RCC, the cancer-specific survival rate is 81.7%, in contrast to 62.3% in individuals with normal weights. Similarly, in patients with RCC, the preoperative BMI is an independent parameter that significantly influences clinical outcome. In a recent meta-analysis, individuals with higher BMI had better overall survival. 4 A similar association is seen in RCC patients on chemotherapy. RCC patients with an associated BMI of less than 25 are more likely to manifest the toxic effects of chemotherapeutic agents, such as sorafenib.It is obvious from the aforementioned examples that there is a close association between BMI and the risk of developing RCC. Further large-scale studies are required to corroborate these findings. Shailendra Kapoor M.D.Private Practice, Mechanicsville, Virginia, USA shailendrakapoor@yahoo.com Conflict of interestNone declared.