Impact of Body Composition in Overweight and Obese Patients With Localised Renal Cell Carcinoma

Abstract

Background/Aim: To investigate the impact of body composition on morbidity and mortality at the initial diagnosis of localised renal cell carcinoma (RCC) in patients with overweight or obesity. Patients and Methods: Sarcopenia was defined using sex-specific cutoff points and other body composition parameters by median values with computed tomography imaging. Results: Among the 96 patients, 40 had sarcopenia (43.0%) at diagnosis. Body composition had no effect on morbidity and 5-year diseasefree survival contrary to the classic factors (p<0.05). In the subgroup of obese patients, those with sarcopenia had a poor prognosis (p=0.04) but not in the population with overweight (p=0.9). Conclusion: Sarcopenia was frequently associated with localised RCC at the initial diagnosis. Body composition did not affect morbidity or outcomes. BMI was involved in morbidity and there was paradoxically longer survival in the obesity group.

The association of body composition with postoperative complications and length of hospital stay after radical or partial nephrectomy in patients with renal cell cancer: a multicenter population-based cohort study

“…Our findings for higher SMD and lower risk of extended LOHS and a potential lower risk of major complications are contrary to a small French study ( 12 ). Darbas et al included 96 patients with localized RCC receiving partial or radial nephrectomy and found no difference in occurrence of post-surgical infections or LOHS according to SMD ( 12 ). Nevertheless, this study may have been underpowered and only included overweight and obese patients.…”

“…We found no statistically significant association between SATI and risk of (major) complications or extended LOHS which is in line with three other studies (12,26,30).…”

“…Ioffe et al reported no significant association of VAT with complications or LOHS in a US study including 118 patients with RCC treated with minimally invasive partial nephrectomy (26). Darbas et al showed no association between VATI and LOHS (12,26). A Chinese study in 76 patients with stage I-III RCC treated with laparoscopic radical nephrectomy showed that higher VAT was associated with postoperative complications and extended LOHS, unadjusted for potential confounders (27).…”

The role of sarcopenia in treatment-related outcomes in patients with renal cell carcinoma: A systematic review and meta-analysis

“…First author, [Ref] Noguchi, [12] 2020 72.3% 15.4% 80.2% 18.5% --------Cushen, [13] 2014 --------68.0% 7.0% 92.5% 16.5% Psutka, [7] [8] 2015 93.7% 51.0% 87.0% 48.0% --------Gu, [14] 2017 37.5% 7% 62% 25% --------Ishihara*, [9] 2018 77.5% 17% 87.5% 43.5% ----25.5% 5.0% 74.0% 18.0% Darbas, [15] 2020 94.0% 65.0% 93.5% 80.5% --------Auclin, [15] 2017 ------------Lee*, [17] 2021 75.7% 5% 43.9% 2% ----22.0% 0.0% 56.8% 0.0% Fukushima, [18] [19] 2021 86.8% 52.0% 96.0% 73.5% --------Ishihara †, [20] [22] 2015 36.0% 3.5% 64.0% 32.0% --------Buchler, [23] 2020 --------43.5% -60.5% -Lee †, [24] 2021 95.0% 81.0% 100% 93.5% 96.5% 88.0% 100% 99.0% ----Mao ‡, [25] review of the three quality assessment areas, and the risk of bias in some studies with relatively low quality [13,21,26] is mainly due to the lack of control of the most important confounding factors such as age and the inadequacy of follow-up investigation. We conducted sensitivity analysis by deleting each study in turn, especially those with deviation risk after quality assessment (Fig.…”

Utilizing Computed Tomography to Analyze the Morphomic Change between Patients with Localized and Metastatic Renal Cell Carcinoma: Body Composition Varies According to Cancer Stage

“…Skeletal muscle has been shown to have a great influence on the immune system; therefore, it has an influence on tumor progression [ 10 ]. The effect of skeletal muscle mass in patients with localized, locally advanced, and metastatic RCC have been investigated in some studies; however, the results have been inconclusive [ 11 , 12 , 13 ]. Cancer may have impact on body composition, while body composition may also potentially influence the outcome of cancers.…”