Abstract
Purpose
To determine whether individual and/or cumulative components of metabolic syndrome (obesity, hypertension, dyslipidemia, and hyperglycemia) are associated with pathologic features of kidney cancer.
Patients and methods
A review of our kidney tumor database identified 462 patients who underwent partial or radical nephrectomy for renal cell carcinoma. The NCEP ATP-III criteria were used to define metabolic syndrome (MetS). Linear fixed effects modeling and ordinal logistic regression examined the relationship between MetS (individual and cumulative components) and pathologic characteristics.
Results
Two hundred and seventy-eight men and 184 women with a median age of 58 years, BMI of 31 kg/m2, tumor size of 3.7 cm, and nephrometry score of 6 were included. Ninety-seven (21 %) patients met NCEP ATP-III criteria for MetS. Hypertension was the only individual component of MetS associated with pathologic features of kidney cancer including increased tumor size [geometric mean ratio 1.17 (1.05–1.32), P = 0.03], higher tumor grade [OR 1.49 (1.03–2.17), P = 0.04], increasing nephrometry score [OR 1.77 (1.28–2.48), P = 0.001], and non-clear cell histology [OR 1.42 (1.01–2.02), P = 0.05]. Furthermore, combinations of MetS components were associated with increased tumor grade (P = 0.02), tumor stage (P = 0.02), nephrometry score (P ≤ 0.001), and non-clear cell histology (P = 0.02), only when hypertension was included.
Conclusion
MetS is composed of four risk factors each implicated in carcinogenesis. We identified hypertension as the primary component associated with specific pathologic features of kidney cancer. Further studies are necessary to elucidate whether the effect of hypertension is a function of severity and/or chronicity.
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Acknowledgments
The authors acknowledge the support of the Keith and Linda Harring Urologic Research Fund at the Penn State Milton S. Hershey Medical Center. This project was supported in part by the National Center for Research Resources and the National Center for Advancing Translational Sciences, National Institutes of Health, through Grant UL1 TR000127.
Author’s contribution
Neil J. Kocher was involved in project development, data collection, and manuscript writing; Chris Rjepaj was involved in data collection and manuscript review; Haley Robyak was involved in data collection and review of manuscript; Erik Lehman was involved in statistical analysis and manuscript review; Jay D. Raman was involved in project development, data collection, and manuscript writing and review.
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For this retrospective study, formal consent was not required.
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Kocher, N.J., Rjepaj, C., Robyak, H. et al. Hypertension is the primary component of metabolic syndrome associated with pathologic features of kidney cancer. World J Urol 35, 67–72 (2017). https://doi.org/10.1007/s00345-016-1850-2
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DOI: https://doi.org/10.1007/s00345-016-1850-2