A lower psoas muscle volume was associated with a higher rate of recurrence in male clear cell renal cell carcinoma


Autoři: Go Noguchi aff001;  Takashi Kawahara aff002;  Kota Kobayashi aff001;  Sohgo Tsutsumi aff001;  Shinji Ohtake aff003;  Kimito Osaka aff001;  Susumu Umemoto aff001;  Noboru Nakaigawa aff003;  Hiroji Uemura aff002;  Takeshi Kishida aff001;  Masahiro Yao aff003
Působiště autorů: Department of Urology, Kanagawa Cancer Center, Yokohama, Japan aff001;  Departments of Urology and Renal Transplantation, Yokohama City University Medical Center, Yokohama, Japan aff002;  Department of Urology, Yokohama City University Graduate School of Medicine, Yokohama, Japan aff003
Vyšlo v časopise: PLoS ONE 15(1)
Kategorie: Research Article
prolekare.web.journal.doi_sk: 10.1371/journal.pone.0226581

Souhrn

Background

Sarcopenia is defined as a low skeletal muscle volume. Recent studies have reported that sarcopenia is associated with a poor prognosis in various cancers. The purpose of this study is to evaluate the correlation between the psoas muscle volume and recurrence-free survival in patients with localized clear cell renal cell carcinoma (ccRCC).

Methods

A total of 316 male patients with localized ccRCC who underwent radical nephrectomy at Yokohama City University Hospital (Yokohama, JAPAN) and Kanagawa Cancer Center (Yokohama, JAPAN) between 2002 and 2018 were enrolled in this study. The psoas muscle index (PMI) was calculated by normalizing the psoas muscle area on the contralateral side of the tumor on axial CT, which was calculated at the level of L4 (mm2) divided by the square of the body height (m2). We divided patients into two groups based on the median PMI (409.64mm2/m2).

Results

The lower PMI group showed poorer recurrence-free survival (RFS) than the higher PMI group (p = 0.030). Regarding 5-year RFS, a lower PMI was a significant predictor of recurrence (p = 0.022, hazard ratio (HR): 2.306) and a multivariate analysis revealed that a lower PMI (<median, p = 0.035, HR: 2.167), tumor size >4 cm (p = 0.044, HR: 2.341), and pathological stage >2 (p<0.001, HR: 3.660) were independent risk factors for poor RFS.

Conclusions

The presence of sarcopenia (lower PMI) was found to be associated with poor RFS in male ccRCC patients. The PMI might serve as a measure of patient frailty and might be useful for prognostic risk stratification in ccRCC.

Klíčová slova:

Cancer risk factors – Nephrectomy – Prognosis – Renal cell carcinoma – Sarcopenia – Skeletal muscles – Surgical and invasive medical procedures – Radical nephrectomy


Zdroje

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2020 Číslo 1

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