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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References
Howlader N, Noone AM, Krapcho M et al SEER Cancer Statistics Review, 1975–2012. http://seer.cancer.gov/csr/1975_2012/, based on November 2014 SEER data submission, posted to the SEER web site, April 2015. Last accessed 14 Feb 2016
Mathew A, Devesa SS, Fraumeni JF Jr, Chow WH (2002) Global increases in kidney cancer incidence, 1973–1992. Eur J Cancer Prev 11:171–178
Weikert S, Ljungberg B (2010) Contemporary epidemiology of renal cell carcinoma: perspectives of primary prevention. World J Urol 28:247–252
Siegel R, Naishadham D, Jemal A (2012) Cancer statistics, 2012. CA Cancer J Clin 62:10–29
Benichou J, Chow WH, McLaughlin JK, Mandel JS, Fraumeni JF Jr (1998) Population attributable risk of renal cell carcinoma in Minnesota. Am J Epidemiol 148:424–430
Renehan AG, Tyson M, Egger M, Heller RF, Zwahlen M (2008) Body-mass index and incidence of cancer: a systematic review and meta-analysis of prospective observational studies. Lancet 371:569–578
Chow WH, Gridley G, Fraumani JF Jr, Jarvholm B (2000) Obesity, hypertension, and the risk of kidney cancer in men. N Engl J Med 343:1305–1311
Flaherty KT, Fuchs CS, Colditz GA et al (2005) A prospective study of body mass index, hypertension, and smoking and the risk of renal cell carcinoma (United States). Cancer Cause Control 16:1099–1106
Weikert S, Boeing H, Pischon T et al (2008) Blood pressure and risk of renal cell carcinoma in the European prospective investigation into cancer and nutrition. Am J Epidemiol 167:438–446
Joh HK, Willett WC, Cho E (2011) Type 2 diabetes and the risk of renal cell carcinoma in women. Diabetes Care 34:1552–1556
Zhang GM, Zhu Y, Ye DW (2014) Metabolic syndrome and renal cell carcinoma. World J Surg Oncol 12:236. doi:10.1186/1477-7819-12-236
Expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (2001) Executive summary of the third report of the National Cholesterol Education Program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III). JAMA 285:2486–2497
Beltrán-Sánchez H, Harhay MO, Harhay MM, McElligott S (2013) Prevalence and trends of metabolic syndrome in the adult US population, 1999–2010. J Am Coll Cardiol 62:697–703
Ford ES, Giles WH, Dietz WH (2002) Prevalence of the metabolic syndrome among US adults: findings from the third National Health and Nutrition Survey. JAMA 287:356–359
Bulut S, Aktas BK, Erkmen AE et al (2014) Metabolic syndrome prevalence in renal cell cancer patients. Asian Pac J Cancer Prev 15:7925–7928
Gago-Dominguez M, Castelao JE, Yuan JM, Ross RK, Yu MC (2002) Lipid peroxidation: a novel and unifying concept of the etiology of renal cell carcinoma (United States). Cancer Causes Control 13:287–293
Colt JS, Schwartz K, Graubard BI et al (2011) Hypertension and risk of renal cell carcinoma among white and black Americans. Epidemiology 22:797–804
Corrao G, Scotti L, Bagnardi V, Sega R (2007) Hypertension, antihypertensive therapy and renal-cell cancer: a meta-analysis. Curr Drug Saf 2:125–133
Shapiro JA, Williams MA, Weiss NS et al (1999) Hypertension, antihypertensive medication use, and risk of renal cell carcinoma. Am J Epidemiol 149:521–530
Fryzek JP, Poulsen AH, Johnsen SP et al (2005) A cohort study of antihypertensive treatments and risk of renal cell cancer. Br J Cancer 92:1302–1306
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