Body composition may be related to survival in clear cell renal cell carcinoma (ccRCC) patients but studies have not simultaneously considered adipose and muscle tissue quantity and radiodensity.
We analyzed data from 1,022 ccRCC patients who underwent nephrectomy between 2000 -2020 at Memorial Sloan Kettering Cancer Center. Skeletal muscle, visceral adipose, and subcutaneous adipose tissue index (SMI, VATI, SATI respectively; cm2/m2) and radiodensity (SMD, VATD, SATD respectively; Hounsfield Units [HU]) were assessed from non-contrast pre-surgical computed tomography scans; clinical and demographic characteristics were available from the time of surgery. Hazard ratios (HR) and confidence intervals (CI) were estimated for overall (OS) and disease-free survival (DFS) through March 2023 in multivariable models that simultaneously accounted for all body composition measures.
Median age was 58 years, 69% were male, and 90% White. There were 169 OS events over 8,392 person-years, and 253 DFS events over 7,753 person-years of follow-up. In adjusted analyses, poor OS was associated with lower SMD (-10 HU, HR (95% CI): 1.37 [1.05, 1.77]), and greater VATD (+10 HU: 1.66 [1.06, 2.59]), with similar findings for DFS. Poor survival was also associated with greater VATI (+40 cm2/m2, OS: 1.32 [0.97, 1.79]; DFS: 1.33 [1.04, 1.71]). Associations with SMD were limited to patients with stage 1/2 disease.
Radiodensities of skeletal muscle and visceral adipose tissue may be novel pre-surgical prognostic factors for ccRCC patients.
Findings underscore the importance of evaluating the full range of body composition features simultaneously in multivariable models.
Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology. 2024 Jul 29 [Epub ahead of print]
Patrick T Bradshaw, Linnea T Olsson, Alejandro Sanchez, Andrea Knezevic, Oguz Akin, Jessica M Scott, A Ari Hakimi, Paul Russo, Bette J Caan, Marina Mourtzakis, Helena Furberg
University of California, Berkeley, Berkeley, CA, United States., University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States., Huntsman Cancer Institute, Salt Lake City, UT, United States., Memorial Sloan Kettering Cancer Center, New York, NY, United States., Memorial Sloan Kettering Cancer Center, New York, New York, United States., Kaiser Permanente, Oakland, CA, United States., University of Waterloo, Waterloo, Ontario, Canada.