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Erschienen in:

01.07.2024 | Urologic Oncology

A Nomogram Including Sarcopenia for Predicting Progression-Free Survival in Patients with Localized Papillary Renal Cell Carcinoma: A Retrospective Cohort Study

verfasst von: Wenhui Su, MD, Yukun Wu, PhD, MD, Shufen Liao, BN, Zhiqiang Zhang, MD, Yubing Zhang, MD, Wei Ou, PhD, MD, Jiajie Yu, MD, Fangzheng Xiang, MD, Cheng Luo, PhD, MD, Fufu Zheng, PhD, MD

Erschienen in: Annals of Surgical Oncology | Ausgabe 9/2024

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Abstract

Background

Because of to the removal of subclassification of papillary renal cell carcinoma (pRCC), the survival prognostification of localized pRCC after surgical treatment became inadequate. Sarcopenia was widely evaluated and proved to be a predictive factor for prognosis in RCC patients. Therefore, we comprehensively investigated the survival prediction of the body composition parameters for localized pRCC.

Methods

Patients pathologically diagnosed with pRCC between February 2012 and February 2022 in our center were enrolled. The body composition parameters, including skeletal muscle index (SMI), subcutaneous adipose tissue (SAT), and perirenal adipose tissue (PRAT), were measured by the images of preoperative computed tomography (CT). The primary outcome was set as progression-free survival (PFS), and the cutoff values of body composition parameters were calculated by using the Youden from receiver operating characteristic curve (ROC) curves. Univariate and multivariate Cox proportional regression analyses were performed to explore independent risk factors for survival prediction. Then, significant factors were used to construct a prognostic nomogram. The performance of the nomogram was evaluated by Harrell’s C-index, calibration curves and time-dependent ROC curves.

Results

A total of 105 patients were enrolled for analysis. With a median follow-up time of 30.48 months, 25 (23.81%) patients experienced cancer progression. The percentage of sarcopenia was 74.29%. Univariate Cox analysis identified that gender, PRAT, SAT, skeletal muscle (SM), sarcopenia, surgical technique, and tumor diameter were associated with progression. Further multivariate analysis showed that sarcopenia (hazard ratio [HR] 0.15, 95% confidence interval [CI] 0.03–0.66), SAT (HR 6.36, 95% CI 2.39–16.93), PRAT (HR 4.66, 95% CI 1.77–12.27), tumor diameter (HR 0.35, 95% CI 0.14–0.86), and surgical technique (HR 2.85, 95% CI 1.06–7.64) were independent risk factors for cancer progression. Then, a prognostic nomogram based on independent risk factors was constructed and the C-index for progression prediction was 0.831 (95% CI 0.761–0.901), representing a reasonable discrimination, the calibration curves, and the time-dependent ROC curves verified the good performance of the nomogram.

Conclusions

A prognostic nomogram, including sarcopenia, SAT, PRAT, tumor diameter, and surgical technique, was constructed to calculate the probability of progression for localized pRCC patients and needs further external validation for clinical use in the future.
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Metadaten
Titel
A Nomogram Including Sarcopenia for Predicting Progression-Free Survival in Patients with Localized Papillary Renal Cell Carcinoma: A Retrospective Cohort Study
verfasst von
Wenhui Su, MD
Yukun Wu, PhD, MD
Shufen Liao, BN
Zhiqiang Zhang, MD
Yubing Zhang, MD
Wei Ou, PhD, MD
Jiajie Yu, MD
Fangzheng Xiang, MD
Cheng Luo, PhD, MD
Fufu Zheng, PhD, MD
Publikationsdatum
01.07.2024
Verlag
Springer International Publishing
Erschienen in
Annals of Surgical Oncology / Ausgabe 9/2024
Print ISSN: 1068-9265
Elektronische ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-024-15666-2

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