Sarcopenia as a poor prognostic indicator for renal cell carcinoma patients undergoing nephrectomy in China: A multicenter study

Mao, Weipu; Wang, Keyi; Zhang, Hui; Lü, Hongmei; Sun, Si; Tian, Changxiu; Wu, Zhuang; Wu, Jianping; Xu, Bin; Xu, Huae; Chen, Ming

doi:10.1002/ctm2.270

Cited by 16 publications

(24 citation statements)

References 10 publications

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“…Studies have confirmed that the development of sarcopenia is a risk factor for poor survival time of patients with colon or liver cancer ( 5 , 6 ). Our previous study also showed that sarcopenia is a factor which can affect the poor prognosis of OS and CSS in RCC patients ( 7 ). The potential reasons might be the reduced treatment tolerance, increased toxic reaction of chemotherapeutic drugs, prolonged length of hospital stay, and increased postoperative complications.…”

Section: Introductionmentioning

confidence: 83%

High Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio Are Associated With Sarcopenia Risk in Hospitalized Renal Cell Carcinoma Patients

Mao

et al. 2021

Front. Oncol.

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PurposeThis study aimed i) to identify the best cutoff points of neutrophil–lymphocyte ratio (NLR) and platelet–lymphocyte ratio (PLR) that predict sarcopenia and ii) to illustrate the association between sarcopenia risk and NLR or PLR in renal cell carcinoma (RCC) patients undergoing laparoscopic partial or radical nephrectomy.MethodsA total of 343 RCC patients who underwent laparoscopic partial or radical nephrectomy between 2014 and 2019 were enrolled in our study. Sarcopenia was assessed by lumbar skeletal muscle index (SMI). Receiver operating characteristic (ROC) curve was used to identify the best cutoff point of NLR or PLR to predict sarcopenia risk. Univariate and multivariate logistic regression and dose–response analysis curves of restricted cubic spline function were conducted to assess the relationship between sarcopenia and NLR or PLR.ResultsThe best cutoff points of NLR >2.88 or PLR >135.63 were confirmed by the ROC curve to predict sarcopenia risk. Dose–response curves showed that the risk of sarcopenia increased with raising NLR and PLR. Patients with NLR >2.88 or PLR >135.63 had a higher sarcopenia risk than those in the NLR ≤2.8 or PLR ≤135.63 group, respectively. By adjusting for all variables, we found that patients with NLR >2.88 and PLR >135.63 had 149% and 85% higher risk to develop sarcopenia, respectively, than those with NLR ≤2.8 (aOR = 2.49; 95% CI = 1.56–3.98; p < 0.001) or PLR ≤135.63 (aOR = 1.85; 95% CI = 1.16–2.95; p = 0.010).ConclusionIn RCC patients receiving laparoscopic partial or radical nephrectomy, NLR and PLR, which were biomarkers of systemic inflammation, were associated with sarcopenia risk.

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Section: Introductionmentioning

confidence: 83%

High Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio Are Associated With Sarcopenia Risk in Hospitalized Renal Cell Carcinoma Patients

Mao

et al. 2021

Front. Oncol.

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“…According to previous studies, AGS = 0 means ALB > 41.7 g/L and GLB <28.6 g/L, AGS = 2 means ALB <41.7 g/L and GLB > 28.6 g/L, and AGS = 1 for the remaining patients ( 8 ). The diagnosis of sarcopenia was determined based on previous studies ( 12 ). CAS was defined as follows: patients with low AGS (AGS = 0) and non-sarcopenia were included in CAS grade 1, patients with high AGS (AGS = 1/2) and sarcopenia were included in CAS grade 3, and the remaining patients were included in CAS grade 2.…”

Section: Methodsmentioning

confidence: 99%

“…Recently, sarcopenia was reported to be connected to inflammatory diseases, malignancies, and malnutrition ( 10 ). Sarcopenia, in particular, is a poor prognostic indicator in various tumors, including hepatocellular carcinoma, gastroesophageal tumor, colorectal cancer, and urothelial carcinomas ( 11 ), and our previous study found that sarcopenia is a risk factor for the survival time of cancer patients, including RCC and bladder cancer ( 12 , 13 ).…”

Section: Introductionmentioning

confidence: 97%

Combination of Albumin-Globulin Score and Sarcopenia to Predict Prognosis in Patients With Renal Cell Carcinoma Undergoing Laparoscopic Nephrectomy

et al. 2021

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We conducted a multicenter clinical study to construct a novel index based on a combination of albumin-globulin score and sarcopenia (CAS) that can comprehensively reflect patients' nutritional and inflammatory status and assess the prognostic value of CAS in renal cell carcinoma (RCC) patients. Between 2014 and 2019, 443 patients from 3 centers who underwent nephrectomy were collected (343 in the training set and 100 in the test set). Kaplan-Meier curves were employed to analyze the impact of albumin-globulin ratio (AGR), albumin-globulin score (AGS), sarcopenia, and CAS on overall survival (OS) and cancer-specific survival (CSS) in RCC patients. Receiver operating characteristic (ROC) curves were used to assess the predictive ability of AGR, AGS, sarcopenia, and CAS on prognosis. High AGR, low AGS, and nonsarcopenia were associated with higher OS and CSS. According to CAS, the training set included 60 (17.5%) patients in grade 1, 176 (51.3%) patients in grade 2, and 107 (31.2%) patients in grade 3. Lower CAS was linked to longer OS and CSS. Multivariate Cox regression analysis revealed that CAS was an independent risk factor for OS (grade 1 vs. grade 3: aHR = 0.08; 95% CI: 0.01–0.58, p = 0.012; grade 2 vs. grade 3: aHR = 0.47; 95% CI: 0.25–0.88, p = 0.018) and CSS (grade 1 vs. grade 3: aHR = 0.12; 95% CI: 0.02–0.94, p = 0.043; grade 2 vs. grade 3: aHR = 0.31; 95% CI: 0.13–0.71, p = 0.006) in RCC patients undergoing nephrectomy. Additionally, CAS had higher accuracy in predicting OS (AUC = 0.687) and CSS (AUC = 0.710) than AGR, AGS, and sarcopenia. In addition, similar results were obtained in the test set. The novel index CAS developed in this study, which reflects patients' nutritional and inflammatory status, can better predict the prognosis of RCC patients.

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“…Kidney cancer is insensitive to radiotherapy and chemotherapy, and surgery remains the mainstay of treatment for kidney cancer. However, approximately 30% of patients with kidney cancer develop metastasis on initial diagnosis, and approximately 25% of patients with localized kidney cancer may develop local recurrence or distant metastasis after surgery [ 5 , 6 ]. Owing to recurrence or distant metastasis, the 5-year survival rate of patients with advanced kidney cancer is extremely low, approximately 5–10% [ 7 , 8 ].…”

Section: Introductionmentioning

confidence: 99%

Current status of research on exosomes in general, and for the diagnosis and treatment of kidney cancer in particular

Mao

Wang²,

Wu³

et al. 2021

J Exp Clin Cancer Res

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Kidney cancer is a common urological tumour. Owing to its high prevalence and mortality rate, it is the third most malignant tumour of the urinary system, followed by prostate and bladder cancers. It exerts a high degree of malignancy, and most of the distant metastasis occurs at an early stage; it is insensitive to chemoradiotherapy and easily develops drug resistance. The current treatment for kidney cancer mainly includes surgery, interventional embolization and targeted therapy; however, the treatment efficacy is poor. In recent years, the role of exosomes as mediators of intercellular communication and information exchange in the tumour microenvironment in tumour pathogenesis has attracted much attention. Exosomes are rich in bioactive substances such as nucleic acids, proteins and lipids and are involved in angiogenesis, immune regulation, drug resistance, formation of pre-metastatic niche, invasion and metastasis. This article reviews the ongoing research and applications of exosomes for the diagnosis and treatment of kidney cancer.

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Sarcopenia as a poor prognostic indicator for renal cell carcinoma patients undergoing nephrectomy in China: A multicenter study

Cited by 16 publications

References 10 publications

High Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio Are Associated With Sarcopenia Risk in Hospitalized Renal Cell Carcinoma Patients

High Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio Are Associated With Sarcopenia Risk in Hospitalized Renal Cell Carcinoma Patients

Combination of Albumin-Globulin Score and Sarcopenia to Predict Prognosis in Patients With Renal Cell Carcinoma Undergoing Laparoscopic Nephrectomy

Current status of research on exosomes in general, and for the diagnosis and treatment of kidney cancer in particular

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