images. Moreover, the modified Glasgow prognostic score (mGPS), was measured based on C-reactive protein (CRP) and albumin levels (score: 2, CRP>1.0 mg/dL and albumin<3.5 gd/L; score 1, CRP>1.0 mg/dL; score 0, CRP¼1.0 mg/dL). Progression-free survival (PFS) and overall survival (OS) were analyzed using the Kaplan-Meier method and Cox proportional hazard models.RESULTS: Overall, 45 (63.4%) mRCC patients had sarcopenia, while 53 (74.6%), 10 (14.1%), and 8 (11.3%) patients had an mGPS of 0, 1, and 2, respectively. The correlations between sarcopenia and mGPS was marginally significant (p¼0.0534). Sarcopenic patients had significantly inferior PFS and OS compared to non-sarcopenic patients (median PFS 7.6 vs. 18.2 months, p¼0.0004 and OS 22.3 months vs. not reached, p¼0.0019, respectively). Patients with higher mGPS also had significantly inferior PFS and OS (median PFS 11.5, 10.9, and 4.12 months for score 0, 1, and 2, p<0.0001 and OS 47.2, not reached, and 5.28 months, p<0.0001, respectively). Multivariate analysis revealed that sarcopenia was an independent predictor of shorter PFS (p¼0.0258), whereas the mGPS was an independent predictor of shorter OS (p¼0.0026).CONCLUSIONS: Sarcopenia and the mGPS, are independent prognostic factors in mRCC patients receiving first-line sunitinib treatment.