MADRID, SPAIN (UroToday.com) - The presence of sarcopenia is an emerging prognostic variable in oncology as decreased skeletal muscle mass is associated with poor nutritional status and cachexia, and, as a result, worse outcomes. The authors of this study looked to see whether sarcopenia was predictive of worse outcomes in patients with metastatic renal cell carcinoma (mRCC).
The study cohort consisted of 96 patients with mRCC, 26 who developed mRCC subsequent to curative resection and 70 with mRCC on presentation, 34 of whom underwent cytoreductive nephrectomy. The presence or absence of sarcopenia was determined by calculation of the area of all skeletal muscle at vertebral level L3 measured on axial imaging slices and normalized to height. A threshold of less than 44.1cm2/m2 for men and 34.7cm2/m2 for women was used to define sarcopenia.
Median overall survival (OS) in this study cohort was 25 months. The authors found that the presence of sarcopenia was associated with a 2-fold increased risk of death, which was statistically significant. Other significant predictors of worse OS were elevated LDH, low albumin, and shorter disease-free interval (< 12 months). The authors looked at the 34 patients who underwent cytoreductive nephrectomy stratified by the presence or absence of sarcopenia. They found that while both those with and without sarcopenia both experienced improved OS with cytoreductive nephrectomy, patients who were not sarcopenic appeared to benefit much more than those who were sarcopenic.
The authors concluded that the presence or absence of sarcopenia could be used as a prognostic metric in patients with mRCC and could help to determine patients likely to benefit more significantly from cytoreductive nephrectomy.
Presented by Fukushima H, Koga F, Nakanishi Y, and Tobisu K at the 30th Annual European Association of Urology (EAU) Congress - March 20 - 24, 2015 - IFEMA - Feria de Madrid - Madrid, Spain
Department of Urology, Tokyo Metropolitan Cancer and Infectious diseases Center Komagome Hospital
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Reported by Timothy Ito, MD, medical writer for UroToday.com