A lower psoas muscle volume was associated with a higher rate of recurrence in male clear cell renal cell carcinoma

English version

Autoři: Go Noguchi ^aff001; Takashi Kawahara ^aff002; Kota Kobayashi ^aff001; Sohgo Tsutsumi ^aff001; Shinji Ohtake ^aff003; Kimito Osaka ^aff001; Susumu Umemoto ^aff001; Noboru Nakaigawa ^aff003; Hiroji Uemura ^aff002; Takeshi Kishida ^aff001; Masahiro Yao ^aff003
Působiště autorů: Department of Urology, Kanagawa Cancer Center, Yokohama, Japan ^aff001; Departments of Urology and Renal Transplantation, Yokohama City University Medical Center, Yokohama, Japan ^aff002; Department of Urology, Yokohama City University Graduate School of Medicine, Yokohama, Japan ^aff003
Vyšlo v časopise: PLoS ONE 15(1)
Kategorie: Research Article
prolekare.web.journal.doi_sk: https://doi.org/10.1371/journal.pone.0226581

Souhrn

Background

Sarcopenia is defined as a low skeletal muscle volume. Recent studies have reported that sarcopenia is associated with a poor prognosis in various cancers. The purpose of this study is to evaluate the correlation between the psoas muscle volume and recurrence-free survival in patients with localized clear cell renal cell carcinoma (ccRCC).

Methods

A total of 316 male patients with localized ccRCC who underwent radical nephrectomy at Yokohama City University Hospital (Yokohama, JAPAN) and Kanagawa Cancer Center (Yokohama, JAPAN) between 2002 and 2018 were enrolled in this study. The psoas muscle index (PMI) was calculated by normalizing the psoas muscle area on the contralateral side of the tumor on axial CT, which was calculated at the level of L4 (mm²) divided by the square of the body height (m²). We divided patients into two groups based on the median PMI (409.64mm²/m²).

Results

The lower PMI group showed poorer recurrence-free survival (RFS) than the higher PMI group (p = 0.030). Regarding 5-year RFS, a lower PMI was a significant predictor of recurrence (p = 0.022, hazard ratio (HR): 2.306) and a multivariate analysis revealed that a lower PMI (<median, p = 0.035, HR: 2.167), tumor size >4 cm (p = 0.044, HR: 2.341), and pathological stage >2 (p<0.001, HR: 3.660) were independent risk factors for poor RFS.

Conclusions

The presence of sarcopenia (lower PMI) was found to be associated with poor RFS in male ccRCC patients. The PMI might serve as a measure of patient frailty and might be useful for prognostic risk stratification in ccRCC.

Klíčová slova:

Surgical and invasive medical procedures – Sarcopenia – Skeletal muscles – Prognosis – Cancer risk factors – Renal cell carcinoma – Nephrectomy – Radical nephrectomy

Zdroje

1. Moch H, Gasser T, Amin MB, Torhorst J, Sauter G, Mihatsch MJ: Prognostic utility of the recently recommended histologic classification and revised TNM staging system of renal cell carcinoma: a Swiss experience with 588 tumors. Cancer 2000, 89(3):604–614. 10931460

2. Lam JS, Shvarts O, Leppert JT, Pantuck AJ, Figlin RA, Belldegrun AS: Postoperative surveillance protocol for patients with localized and locally advanced renal cell carcinoma based on a validated prognostic nomogram and risk group stratification system. J Urol 2005, 174(2):466–472; discussion 472; quiz 801. doi: 10.1097/01.ju.0000165572.38887.da 16006866

3. Leibovich BC, Blute ML, Cheville JC, Lohse CM, Frank I, Kwon ED, et al.: Prediction of progression after radical nephrectomy for patients with clear cell renal cell carcinoma. Cancer 2003, 97(7):1663–1671. doi: 10.1002/cncr.11234 12655523

4. Zisman A, Pantuck AJ, Dorey F, Said JW, Shvarts O, Quintana D, et al.: Improved prognostication of renal cell carcinoma using an integrated staging system. J Clin Oncol 2001, 19(6):1649–1657. doi: 10.1200/JCO.2001.19.6.1649 11250993

5. Frank I, Blute ML, Cheville JC, Lohse CM, Weaver AL, Zincke H: An outcome prediction model for patients with clear cell renal cell carcinoma treated with radical nephrectomy based on tumor stage, size, grade and necrosis: the SSIGN score. J Urol 2002, 168(6):2395–2400. 12441925

6. Joglekar S, Nau PN, Mezhir JJ: The impact of sarcopenia on survival and complications in surgical oncology: A review of the current literature. J Surg Oncol 2015, 112(5):503–509. doi: 10.1002/jso.24025 26310812

7. Sabel MS, Lee J, Cai S, Englesbe MJ, Holcombe S, Wang S: Sarcopenia as a prognostic factor among patients with stage III melanoma. Ann Surg Oncol 2011, 18(13):3579–3585. doi: 10.1245/s10434-011-1976-9 21822551

8. Miyamoto Y, Baba Y, Sakamoto Y, Ohuchi M, Tokunaga R, Kurashige J, et al.: Sarcopenia is a Negative Prognostic Factor After Curative Resection of Colorectal Cancer. Ann Surg Oncol 2015, 22(8):2663–2668. doi: 10.1245/s10434-014-4281-6 25564158

9. Harimoto N, Shirabe K, Yamashita YI, Ikegami T, Yoshizumi T, Soejima Y, et al.: Sarcopenia as a predictor of prognosis in patients following hepatectomy for hepatocellular carcinoma. British Journal of Surgery 2013, 100(11):1523–1530. doi: 10.1002/bjs.9258 24037576

10. Okumura S, Kaido T, Hamaguchi Y, Fujimoto Y, Masui T, Mizumoto M, et al.: Impact of preoperative quality as well as quantity of skeletal muscle on survival after resection of pancreatic cancer. Surgery 2015, 157(6):1088–1098. doi: 10.1016/j.surg.2015.02.002 25799468

11. Saitoh-Maeda Y, Kawahara T, Miyoshi Y, Tsutsumi S, Takamoto D, Shimokihara K, et al.: A low psoas muscle volume correlates with a longer hospitalization after radical cystectomy. BMC Urol 2017, 17(1):87. doi: 10.1186/s12894-017-0279-2 28923108

12. Cruz-Jentoft AJ, Baeyens JP, Bauer JM, Boirie Y, Cederholm T, Landi F, et al.: Sarcopenia: European consensus on definition and diagnosis: Report of the European Working Group on Sarcopenia in Older People. Age Ageing 2010, 39(4):412–423. doi: 10.1093/ageing/afq034 20392703

13. Wilson D, Jackson T, Sapey E, Lord JM: Frailty and sarcopenia: The potential role of an aged immune system. Ageing Res Rev 2017, 36:1–10. doi: 10.1016/j.arr.2017.01.006 28223244

14. Psutka SP, Boorjian SA, Moynagh MR, Schmit GD, Costello BA, Thompson RH et al.: Decreased Skeletal Muscle Mass is Associated with an Increased Risk of Mortality after Radical Nephrectomy for Localized Renal Cell Cancer. J Urol 2016, 195(2):270–276. doi: 10.1016/j.juro.2015.08.072 26292038