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Body Mass Index Is Associated With Higher Lymph Node Counts During Retroperitoneal Lymph Node Dissection.
MedLine Citation:
PMID:  22173172     Owner:  NLM     Status:  Publisher    
OBJECTIVE: To determine whether body mass index (BMI) is associated with lymph node counts in patients treated with a primary retroperitoneal lymph node dissection (RPLND). Lymph node counts are a proposed measure of quality assurance for numerous malignancies. Investigation of patient factors associated with lymph node counts are lacking. METHODS: Using the Memorial Sloan-Kettering Testis Cancer Database, we identified 255 patients treated with a primary RPLND for nonseminomatous germ cell tumors (NSGCT) from 1999-2008. The associations between BMI and node counts were evaluated using linear regression models in univariate and multivariable models adjusting for features reported to predict higher node counts (year of surgery, stage, and surgeon volume). RESULTS: Median BMI (IQR) was 26.1 (23.4-28.7) and median (IQR) total node count was 38 (27-53). Median total node count for patients with a BMI <25, 25 to 29, and ≥30 was 35, 42, and 44 nodes, respectively. In a univariate analysis, higher BMI was significantly associated with higher total node counts (coefficient 0.7 nodes for each 1-U increase in BMI; P = .026). Features associated with higher node count on multivariate analysis included high-volume surgeon (P = .047), pathologic stage (P = .017), more recent year of surgery (P < .001), and higher BMI (P = .009). CONCLUSION: Our results suggest for the first time that BMI is independently associated with higher lymph node counts during a lymph node dissection. If confirmed by others, these results may be important when using lymph node counts as a surrogate for adequacy of a lymph node dissection.
R Houston Thompson; Brett S Carver; George J Bosl; Dean Bajorin; Robert Motzer; Darren Feldman; Victor E Reuter; Joel Sheinfeld
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-12-13
Journal Detail:
Title:  Urology     Volume:  -     ISSN:  1527-9995     ISO Abbreviation:  -     Publication Date:  2011 Dec 
Date Detail:
Created Date:  2011-12-16     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0366151     Medline TA:  Urology     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2011 Elsevier Inc. All rights reserved.
Department of Surgery-Urology Service, Memorial Sloan-Kettering Cancer Center, New York, NY.
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