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Annals of Surgical Oncology
Erschienen in:

09.10.2021 | Urologic Oncology

Association Between Sarcopenia and Survival of Patients with Organ-Confined Renal Cell Carcinoma after Radical Nephrectomy

verfasst von: Jongpil Lee, MD, Jungyo Suh, MD, Cheryn Song, MD, PhD, MPH, Dalsan You, MD, PhD, In Gab Jeong, MD, PhD, Bumsik Hong, MD, PhD, Jun Hyuk Hong, MD, PhD, Choung Soo Kim, MD, PhD, Hanjong Ahn, MD, PhD

Erschienen in: Annals of Surgical Oncology | Ausgabe 4/2022

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Abstract

Background

We aimed to describe the effect of preoperative sarcopenia on oncologic outcomes of organ-confined renal cell carcinoma (RCC) after radical nephrectomy.

Patients and Methods

A total of 632 patients with pT1–2 RCC who underwent radical nephrectomy between 2004 and 2014 were retrospectively analyzed. From preoperative computerized tomography (CT) scans, skeletal muscle index (SMI) was measured and gender-specific cutoff values at third lumbar vertebra of 52.4 cm2/m2 for men and 38.5 cm2/m2 for women were used to define sarcopenia. Survivals were compared and associations with sarcopenia were analyzed using Kaplan–Meier log rank tests and Cox proportional hazard regression models. Median follow-up was 83 months.

Results

Of 632 patients, 268 (42.4%) were classified as sarcopenic. The sarcopenic group was more advanced in age (57 versus 53 years) and more predominantly male (71.3% versus 59.9%). Sarcopenic patients had lower body mass index (BMI, 23.0 versus 25.9 kg/m2), but there was no difference in tumor size, stage, or nuclear grade. Sarcopenia was associated with poorer overall survival (OS) and cancer-specific survival (CSS; OS 94.0% versus 82.1%; p < 0.001 and CSS 97.5% versus 91.8%; p < 0.001). On multivariate analysis, sarcopenia was an independent risk factor for all-cause mortality [hazard ratio (HR) 2.58; 95% CI 1.02–6.54] and cancer-specific mortality (HR 3.07; 95% CI 1.38–6.83).

Conclusions

Sarcopenia at diagnosis was an independent risk factor for all-cause and cancer-specific mortality after radical nephrectomy for pT1–2 RCC. These findings underscore the importance of assessing presence of sarcopenia for risk stratification even among surgical candidates.
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Metadaten
Titel
Association Between Sarcopenia and Survival of Patients with Organ-Confined Renal Cell Carcinoma after Radical Nephrectomy
verfasst von
Jongpil Lee, MD
Jungyo Suh, MD
Cheryn Song, MD, PhD, MPH
Dalsan You, MD, PhD
In Gab Jeong, MD, PhD
Bumsik Hong, MD, PhD
Jun Hyuk Hong, MD, PhD
Choung Soo Kim, MD, PhD
Hanjong Ahn, MD, PhD
Publikationsdatum
09.10.2021
Verlag
Springer International Publishing
Erschienen in
Annals of Surgical Oncology / Ausgabe 4/2022
Print ISSN: 1068-9265
Elektronische ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-021-10881-7

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