Association between visceral and subcutaneous adiposity and clinicopathological outcomes in non-metastatic clear cell renal cell carcinoma

Abstract

Introduction: Visceral adiposity has been inconsistently associated with clinicopathologic features and outcomes of clear cell renal cell carcinoma (ccRCC); however, most studies were conducted in non-Western populations. We evaluated the associations between visceral and subcutaneous adiposity and clinicopathological characteristics of non-metastatic ccRCC patients in a Western population. Methods: The medical records of 220 surgically treated ccRCC patients with documented preoperative body mass index (BMI) and computed tomography (CT) scans were retrospectively reviewed. Nineteen patients with stage IV disease were excluded. Visceral (VFA) and subcutaneous fat area (SFA) were computed from preoperative CT scans. Correlations between obesity measures were assessed with Pearson correlation. Associations between obesity measures and pathologic features were evaluated using logistic regression models adjusted for sex. Overall survival (OS) probabilities were estimated using Cox regression analysis. The log-rank test was used for group comparisons. Results: The study cohort comprised 150 men and 51 women. Women had higher SFA (p = 0.01) but lower VFA (p < 0.001) than men. BMI was highly correlated with SFA (r = 0.804) and moderately correlated with VFA (r = 0.542). SFA and VFA were weakly correlated (r = 0.367). An increased BMI was associated with a better OS (p = 0.028). When adjusting for sex, neither SFA nor VFA was significantly associated with tumour grade, stage, or OS. Conclusions: Consistent with prior reports, our study suggests that increased BMI is associated with a better OS for patient with nonmetastatic ccRCC. Despite the high correlation between SFA and BMI, neither SFA nor VFA were significantly associated with tumour stage, grade, or OS in the current study; however, further studies in larger cohorts are required to validate this finding.

Association between visceral adiposity and DDX11 as a predictor of aggressiveness of small clear-cell renal-cell carcinoma: a prospective clinical trial

“…Five studies have examined the VAT content in patients with localized and/or advanced RCC [25]. Among these, three reported that low VAT contents are associated with poor prognosis in patients with RCC [25], and one study reported no association between VAT contents and overall mortality [26]. Park and colleagues reported that the lowest and the highest vs. the second quartiles of the VAT% are associated with a higher risk of recurrence [23].…”

The prognostic value of body fat components in metastasis renal cell carcinoma patients treated with TKIs.

“…5,24 Naturally, BMI was considered as one of the crucial factors to calculate patients' obesity and to predict their prognosis with cancer. 15,[25][26][27][28] However, growing evidence suggested that BMI was only a rough initial measurement and it ignored more information about body fat components on an individual level. 29 Compared with BMI, body fat composition (such as VFA, SFA, and TFA), as a quantitative method by CT image, has recently been focused on its contributions to the progression of RCC.…”

“…12 Nevertheless, the clinical study reported by Mano et al showed that neither SFA nor VFA was associated with tumor stage, grade or OS in a non-metastatic clear cell RCC cohort from the United States. 28 Recently, the significant relationship between high VFA and the progression of clear cell RCC among patients from the Chinese south-eastern coast was shown in the study led by Huang et al 31 These conflicting results clearly indicate that further study about the issue is required. In the current study, we provided more evidence to reveal the prognostic value of body fat composition.…”

Body Composition in Relation to Clinical Outcomes in Renal Cell Cancer: A Systematic Review and Meta-analysis

“…1, Table 1) [5,8,9,, including a total of 6608 patients. Eleven studies concerned perioperative outcomes (Table 2) [8,9,[16][17][18][19][20][21][22][23][24], four studies concerned treatment toxicity (Table 3) [5,[25][26][27], and 16 studies concerned recurrence, progression, and/or mortality (Table 4) [21,23,[27][28][29][30][31][32][33][34][35][36][37][38][39][40].…”

“…All but four studies [16,25,26,31] were single center historical cohort studies. Nineteen studies included a consecutive series of patients while nine studies did not report this [27,28,30,[33][34][35]39] or included participants of a clinical trial [25,31]. Fourteen studies had more than 90% completeness of CT scans, while 14 studies did not report this [16,28,33] or had less than 90% completeness [5,9,18,21,26,27,30,32,[38][39][40].…”