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Japanese Journal of Radiology

Erschienen in:

10.06.2024 | Original Article

The prognostic role of perirenal fat tissue in non-metastatic renal cell carcinoma

verfasst von: Muhammed Said Beşler, Esin Ölçücüoğlu, Erkan Ölçücüoğlu

Erschienen in: Japanese Journal of Radiology | Ausgabe 11/2024

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Abstract

Purpose

The aim of this study was to evaluate the impact of perirenal fat volume and perirenal fat density on prognosis in surgically treated non-metastatic renal cell carcinomas (RCC).

Methods and materials

All consecutive patients who underwent partial or total nephrectomy surgery between March 2019 and December 2021 were assessed. Measurements of perirenal fat volume and perirenal fat density were performed on computed tomography (CT) images. The relationship between progression and perirenal fat parameters was evaluated using ROC analysis, Cox regression analysis, and Kaplan–Meier analysis.

Results

In the study population comprising 118 patients diagnosed with RCC (74.6% male, mean age of 59.1 ± 11.8 years), the median follow-up duration was 43 months (interquartile range: 33–51 months). Perirenal fat volume (AUC: 0.669, 95% CI 0.538–0.799, p = 0.011) and perirenal fat density (AUC: 0.680, 95% CI 0.558–0.803, p = 0.007) demonstrated acceptable discrimination performance in predicting progression. There was a significant association between high perirenal fat volume and high perirenal fat density with poor progression-free survival (HR: 1.007, 95% CI 1.003–1.011, p = 0.001 vs. HR: 1.084, 95% CI 1.033–1.137, p = 0.001; respectively).

Conclusion

High perirenal fat volume and high perirenal fat density are independent predictors for poor progression-free survival. Perirenal fat parameters, easily obtainable from preoperative CT images, may serve as potential tools in predicting the prognosis of non-metastatic RCC.

Hsieh JJ, Purdue MP, Signoretti S, Swanton C, Albiges L, Schmidinger M, et al. Renal cell carcinoma. Nat Rev Dis Primers. 2017;3:17009. https://doi.org/10.1038/nrdp.2017.9.CrossRefPubMedPubMedCentral

Padala SA, Barsouk A, Thandra KC, Saginala K, Mohammed A, Vakiti A, et al. Epidemiology of renal cell carcinoma. World J Oncol. 2020;11(3):79–87. https://doi.org/10.14740/wjon1279.CrossRefPubMedPubMedCentral

Ciccarese C, Strusi A, Arduini D, Russo P, Palermo G, Foschi N, et al. Post nephrectomy management of localized renal cell carcinoma. From risk stratification to therapeutic evidence in an evolving clinical scenario. Cancer Treat Rev. 2023;115:102528. https://doi.org/10.1016/j.ctrv.2023.102528.CrossRefPubMed

Dabestani S, Thorstenson A, Lindblad P, Harmenberg U, Ljungberg B, Lundstam S. Renal cell carcinoma recurrences and metastases in primary non-metastatic patients: a population-based study. World J Urol. 2016;34(8):1081–6. https://doi.org/10.1007/s00345-016-1773-y.CrossRefPubMed

Abou Elkassem AM, Lo SS, Gunn AJ, Shuch BM, Dewitt-Foy ME, Abouassaly R, et al. Role of imaging in renal cell carcinoma: a multidisciplinary perspective. Radiographics. 2021;41(5):1387–407. https://doi.org/10.1148/rg.2021200202.CrossRefPubMed

Ljungberg B, Albiges L, Abu-Ghanem Y, Bensalah K, Dabestani S, Fernández-Pello S, et al. European association of urology guidelines on renal cell carcinoma: the 2019 update. Eur Urol. 2019;75(5):799–810. https://doi.org/10.1016/j.eururo.2019.02.011.CrossRefPubMed

Liu BX, Sun W, Kong XQ. Perirenal fat: a unique fat pad and potential target for cardiovascular disease. Angiology. 2019;70(7):584–93. https://doi.org/10.1177/0003319718799967.CrossRefPubMed

Rajandram R, Perumal K, Yap NY. Prognostic biomarkers in renal cell carcinoma: is there a relationship with obesity? Transl Androl Urol. 2019;8(Suppl 2):S138–46. https://doi.org/10.21037/tau.2018.11.10.CrossRefPubMedPubMedCentral

Tsai JP, Lin DC, Huang WM, Chen M, Chen YH. Comparison of perinephric fat measurements between malignant and benign renal tumours. J Int Med Res. 2022;50(9):3000605221125086. https://doi.org/10.1177/03000605221125086.CrossRefPubMed

10.

Du Y, Yang W, Liu H, Qin C, Tang X, Xu T. Perirenal fat as a new independent prognostic factor in patients with surgically treated clear cell renal cell carcinoma. Clin Genitourin Cancer. 2022;20(1):e75–80. https://doi.org/10.1016/j.clgc.2021.10.006.CrossRefPubMed

11.

Huang H, Chen S, Li W, Wu X, Xing J. High perirenal fat thickness predicts a poor progression-free survival in patients with localized clear cell renal cell carcinoma. Urol Oncol. 2018;36(4):157.e1-157.e6. https://doi.org/10.1016/j.urolonc.2017.12.011.CrossRefPubMed

12.

Rosenquist KJ, Pedley A, Massaro JM, Therkelsen KE, Murabito JM, Hoffmann U, et al. Visceral and subcutaneous fat quality and cardiometabolic risk. JACC Cardiovasc Imaging. 2013;6(7):762–71. https://doi.org/10.1016/j.jcmg.2012.11.021.CrossRefPubMedPubMedCentral

13.

Wang H, Wei Y, Hu X, Pan J, Wu J, Wang B, et al. Fat attenuation ındex of renal cell carcinoma reveals biological characteristics and survival outcome. Front Oncol. 2022;12:786981. https://doi.org/10.3389/fonc.2022.786981.CrossRefPubMedPubMedCentral

14.

Sun Z, Zhang Y, Xia Y, Ba X, Zheng Q, Liu J, et al. Association between CT-based adipose variables, preoperative blood biochemical indicators and pathological T stage of clear cell renal cell carcinoma. Heliyon. 2024;10(2):e24456. https://doi.org/10.1016/j.heliyon.2024.e24456.CrossRefPubMedPubMedCentral

15.

Elkassem AA, Allen BC, Sharbidre KG, Rais-Bahrami S, Smith AD. Update on the role of imaging in clinical staging and restaging of renal cell carcinoma based on the AJCC 8th edition from the AJR special series on cancer staging. AJR Am J Roentgenol. 2021;217(3):541–55. https://doi.org/10.2214/AJR.21.25493.CrossRefPubMed

16.

Liu H, Kong QF, Li J, Wu YQ, Pan KH, Xu B, et al. A meta-analysis for comparison of partial nephrectomy vs. radical nephrectomy in patients with pT3a renal cell carcinoma. Transl Androl Urol. 2021;10(3):1170–8. https://doi.org/10.21037/tau-20-1262.CrossRefPubMedPubMedCentral

17.

Hori S, Tanaka N, Iida K, Nakai Y, Miyake M, Anai S, et al. Impact of radical nephrectomy and partial nephrectomy on actual estimated overall survival compared to life expectancy in patients with renal cell carcinoma. Res Rep Urol. 2021;13:155–65. https://doi.org/10.2147/RRU.S299801.CrossRefPubMedPubMedCentral

18.

Hu H, Liang W, Zhang Z, Liu Z, Chu F, Bao Y, et al. The Utility of perirenal fat in determining the risk of onset and progression of diabetic kidney disease. Int J Endocrinol. 2022;2022:2550744. https://doi.org/10.1155/2022/2550744.CrossRefPubMedPubMedCentral

19.

Klatte T, Rossi SH, Stewart GD. Prognostic factors and prognostic models for renal cell carcinoma: a literature review. World J Urol. 2018;36(12):1943–52. https://doi.org/10.1007/s00345-018-2309-4.CrossRefPubMed

20.

Rakic I, Rakic N, Stephens A, Corsi N, Davis M, Tinsley S, et al. Assessing the impact of lymphovascular invasion on overall survival in surgically treated renal cell carcinoma patients: a nationwide cohort analysis. Urol Oncol. 2023;41(10):435.e1-435.e9. https://doi.org/10.1016/j.urolonc.2023.07.011.CrossRefPubMed

21.

Suárez C, Campayo M, Bastús R, Castillo S, Etxanitz O, Guix M, et al. Prognostic and predictive factors for renal cell carcinoma. Target Oncol. 2018;13(3):309–31. https://doi.org/10.1007/s11523-018-0557-2.CrossRefPubMed

22.

Bruna FA, Romeo LR, Campo-Verde-Arbocco F, Contador D, Gómez S, Santiano F, et al. Human renal adipose tissue from normal and tumor kidney: its influence on renal cell carcinoma. Oncotarget. 2019;10(52):5454–67. https://doi.org/10.18632/oncotarget.27157.CrossRefPubMedPubMedCentral

23.

Campo-Verde-Arbocco F, López-Laur JD, Romeo LR, Giorlando N, Bruna FA, Contador DE, et al. Human renal adipose tissue induces the invasion and progression of renal cell carcinoma. Oncotarget. 2017;8(55):94223–34. https://doi.org/10.18632/oncotarget.21666.CrossRefPubMedPubMedCentral

24.

Zhang Y, Coletta AM, Allen PK, Parikh AM, Cox-Mattin M, Meyer LA, et al. Perirenal adiposity is associated with lower progression-free survival from ovarian cancer. Int J Gynecol Cancer. 2018;28(2):285–92. https://doi.org/10.1097/IGC.0000000000001165.CrossRefPubMedPubMedCentral

25.

Kuo YR, Lee YC, Wang CT, Liu WC, Ou CH, Lin KC, et al. Prognostic value of preoperative radiographic perinephric fat features in renal cell carcinoma patients undergoing surgery. Asian J Surg. 2024;47:2188–94. https://doi.org/10.1016/j.asjsur.2024.02.048.CrossRefPubMed

26.

Ferrando M, Bruna FA, Romeo LR, Contador D, Moya-Morales DL, Santiano F, et al. Renal peritumoral adipose tissue undergoes a browning process and stimulates the expression of epithelial-mesenchymal transition markers in human renal cells. Sci Rep. 2022;12(1):8687. https://doi.org/10.1038/s41598-022-12746-9.CrossRefPubMedPubMedCentral

27.

Ahmadi N, Hajsadeghi F, Conneely M, Mingos M, Arora R, Budoff M, et al. Accurate detection of metabolically active “brown” and “white” adipose tissues with computed tomography. Acad Radiol. 2013;20(11):1443–7. https://doi.org/10.1016/j.acra.2013.08.012.CrossRefPubMed

28.

Preza-Fernandes J, Passos P, Mendes-Ferreira M, Rodrigues AR, Gouveia A, Fraga A, et al. A hint for the obesity paradox and the link between obesity, perirenal adipose tissue and renal cell carcinoma progression. Sci Rep. 2022;12(1):19956. https://doi.org/10.1038/s41598-022-24418-9.CrossRefPubMedPubMedCentral

29.

Mazonakis M, Damilakis J. Computed tomography: what and how does it measure? Eur J Radiol. 2016;85(8):1499–504. https://doi.org/10.1016/j.ejrad.2016.03.002.CrossRefPubMed

30.

Favre G, Grangeon-Chapon C, Raffaelli C, François-Chalmin F, Iannelli A, Esnault V. Perirenal fat thickness measured with computed tomography is a reliable estimate of perirenal fat mass. PLoS ONE. 2017;12(4):e0175561. https://doi.org/10.1371/journal.pone.0175561.CrossRefPubMedPubMedCentral

31.

Ibrahim MM. Subcutaneous and visceral adipose tissue: structural and functional differences. Obes Rev. 2010;11(1):11–8. https://doi.org/10.1111/j.1467-789X.2009.00623.x.CrossRefPubMed

Titel: The prognostic role of perirenal fat tissue in non-metastatic renal cell carcinoma
verfasst von: Muhammed Said Beşler
Esin Ölçücüoğlu
Erkan Ölçücüoğlu
Publikationsdatum: 10.06.2024
Verlag: Springer Nature Singapore
Erschienen in: Japanese Journal of Radiology / Ausgabe 11/2024
Print ISSN: 1867-1071
Elektronische ISSN: 1867-108X
DOI: https://doi.org/10.1007/s11604-024-01609-0

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The prognostic role of perirenal fat tissue in non-metastatic renal cell carcinoma