Body mass index is associated with higher lymph node counts during retroperitoneal lymph node dissection Journal Article


Authors: Thompson, R. H.; Carver, B. S.; Bosl, G. J.; Bajorin, D.; Motzer, R.; Feldman, D.; Reuter, V. E.; Sheinfeld, J.
Article Title: Body mass index is associated with higher lymph node counts during retroperitoneal lymph node dissection
Abstract: 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 19992008. 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 (23.428.7) and median (IQR) total node count was 38 (2753). 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. © 2012 Elsevier Inc. All Rights Reserved.
Keywords: adult; cancer surgery; major clinical study; histopathology; lymph node dissection; quality control; data base; body mass; disease severity; surgeon; non seminomatous germinoma
Journal Title: Urology
Volume: 79
Issue: 2
ISSN: 0090-4295
Publisher: Elsevier Science, Inc.  
Date Published: 2012-02-01
Start Page: 361
End Page: 364
Language: English
DOI: 10.1016/j.urology.2011.04.050
PROVIDER: scopus
PUBMED: 22173172
PMCID: PMC4170790
DOI/URL:
Notes: --- - "Export Date: 1 March 2012" - "CODEN: URGYA" - "Source: Scopus"
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MSK Authors
  1. Dean Bajorin
    416 Bajorin
  2. Robert Motzer
    769 Motzer
  3. Darren Richard Feldman
    172 Feldman
  4. Joel Sheinfeld
    197 Sheinfeld
  5. Brett Stewart Carver
    109 Carver
  6. Victor Reuter
    922 Reuter
  7. George Bosl
    270 Bosl