Skip to main content

Advertisement

SpringerLink
Log in

Adherent perinephric fat affects perioperative outcomes after partial nephrectomy: a systematic review and meta-analysis

  • Review Article
  • Published:
International Journal of Clinical Oncology Aims and scope Submit manuscript

Abstract

To investigate the association of adherent perinephric fat (APF) with perioperative outcomes, we conducted a systematic review and meta-analysis of the literature to clarify the impact of APF in patients undergoing partial nephrectomy. A systematic literature search using the Medline, Scopus, and Cochrane databases was performed in April 2019 and updated in November 2019 to identify studies investigating the effect of APF on perioperative outcomes in patients treated with partial nephrectomy with the aim of evaluating its impact on intraoperative, postoperative and oncological outcomes. The Newcastle–Ottawa Scale (NOS) was used to assess the quality of the included studies. A total of 1534 patients in nine nonrandomized, observational studies met our inclusion criteria. Patients with APF were significantly older (p = 0.0001), had a higher BMI (p = 0.0001) and were predominately male (p = 0.003). APF was associated with a higher operative time (p = 0.001) and higher blood loss (p = 0.002). No significant impact of APF was found in terms of postoperative complications, positive margins or length of stay. APF was also found to be associated with malignant renal histology of RCC on final pathology (p = 0.005). APF was associated with some adverse perioperative outcomes, especially a prolonged operating time and higher blood loss. In addition, APF was also associated with underlying renal malignancy, but the precise causal mechanism requires further exploration.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Escudier B, Porta C, Schmidinger M et al (2019) Renal cell carcinoma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol 30:706–720. https://doi.org/10.1093/annonc/mdz056

    Article  PubMed  CAS  Google Scholar 

  2. Ljungberg B, Albiges L, Abu-Ghanem Y et al (2019) European Association of Urology Guidelines on Renal Cell Carcinoma: the 2019 update. EurUrol 75:799–810. https://doi.org/10.1016/j.eururo.2019.02.011

    Article  Google Scholar 

  3. Larcher A, Fossati N, Tian Z et al (2016) Prediction of complications following partial nephrectomy: implications for ablative techniques candidates. EurUrol 69:676–682. https://doi.org/10.1016/j.eururo.2015.07.003

    Article  Google Scholar 

  4. Mari A, Antonelli A, Bertolo R et al (2017) Predictive factors of overall and major postoperative complications after partial nephrectomy: results from a multicenter prospective study (The RECORd 1 project). Eur J Surg Oncol 43:823–830. https://doi.org/10.1016/j.ejso.2016.10.016

    Article  PubMed  CAS  Google Scholar 

  5. Stephenson AJ, Hakimi AA, Snyder ME et al (2004) Complications of radical and partial nephrectomy in a large contemporary cohort. J Urol 171:130–134. https://doi.org/10.1097/01.ju.0000101281.04634.13

    Article  PubMed  Google Scholar 

  6. Bylund JR, Qiong H, Crispen PL et al (2013) Association of clinical and radiographic features with perinephric “sticky” fat. J Endourol 27:370–373. https://doi.org/10.1089/end.2012.0205

    Article  PubMed  PubMed Central  Google Scholar 

  7. Kawamura N, Saito K, Inoue M et al (2018) Adherent perinephric fat in asian patients: predictors and impact on perioperative outcomes of partial nephrectomy. Urol Int 101:437–442. https://doi.org/10.1159/000494068

    Article  PubMed  Google Scholar 

  8. Davidiuk AJ, Parker AS, Thomas CS et al (2014) Mayo adhesive probability score: an accurate image-based scoring system to predict adherent perinephric fat in partial nephrectomy. EurUrol 66:1165–1171. https://doi.org/10.1016/j.eururo.2014.08.054

    Article  Google Scholar 

  9. Dariane C, Le Guilchet T, Hurel S et al (2017) Prospective assessment and histological analysis of adherent perinephric fat in partial nephrectomies. Urol Oncol Semin Orig Investig 35:39.e9-39.e17. https://doi.org/10.1016/j.urolonc.2016.09.008

    Article  Google Scholar 

  10. Khene Z, Bensalah K, Largent A et al (2018) Role of quantitative computed tomography texture analysis in the prediction of adherent perinephric fat. World J Urol 36:1635–1642. https://doi.org/10.1007/s00345-018-2292-9

    Article  PubMed  CAS  Google Scholar 

  11. Kocher NJ, Kunchala S, Reynolds C et al (2016) Adherent perinephric fat at minimally invasive partial nephrectomy is associated with adverse peri-operative outcomes and malignant renal histology. BJU Int 117:636–641. https://doi.org/10.1111/bju.13378

    Article  PubMed  Google Scholar 

  12. Liberati A, Altman DG, Tetzlaff J et al (2009) The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. J ClinEpidemiol 62:e1-34. https://doi.org/10.1016/j.jclinepi.2009.06.006

    Article  Google Scholar 

  13. Wan X, Wang W, Liu J et al (2014) Estimating the sample mean and standard deviation from the sample size, median, range and/or interquartile range. BMC Med Res Methodol 14:135. https://doi.org/10.1186/1471-2288-14-135

    Article  PubMed  PubMed Central  Google Scholar 

  14. Dindo D, Demartines N, Clavien P-A (2004) Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg 240:205–213

    Article  Google Scholar 

  15. Stang A (2010) Critical evaluation of the Newcastle–Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses. Eur J Epidemiol 25:603–605. https://doi.org/10.1007/s10654-010-9491-z

    Article  Google Scholar 

  16. Which is more generalizable, powerful and interpretable in meta-analyses, mean difference or standardized mean difference?|BMC Medical Research Methodology | Full Text n.d. https://bmcmedresmethodol.biomedcentral.com/articles/https://doi.org/10.1186/1471-2288-14-30. Accessed 7 Apr2020

  17. Cochrane Handbook for Systematic Reviews of Interventions n.d. /handbook. Accessed 7 Apr 2020

  18. StataCorp. (2013) Stata Statistical Software: Release 13. StataCorp LP n.d, College Station

    Google Scholar 

  19. Ahima RS (2006) Adipose tissue as an endocrine organ. Obesity 14:242S-249S. https://doi.org/10.1038/oby.2006.317

    Article  PubMed  CAS  Google Scholar 

  20. Weisberg SP, McCann D, Desai M et al (2003) Obesity is associated with macrophage accumulation in adipose tissue. J Clin Invest 112:1796–1808. https://doi.org/10.1172/JCI19246

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  21. Eckel RH, Grundy SM, Zimmet PZ (2005) The metabolic syndrome. The Lancet 365:1415–1428. https://doi.org/10.1016/S0140-6736(05)66378-7

    Article  CAS  Google Scholar 

  22. Grivennikov SI, Karin M (2011) Inflammatory cytokines in cancer: tumour necrosis factor and interleukin 6 take the stage. Ann Rheum Dis 70:i104–i108. https://doi.org/10.1136/ard.2010.140145

    Article  PubMed  CAS  Google Scholar 

  23. Zheng Y, Espiritu P, Hakky T et al (2014) Predicting ease of perinephric fat dissection at time of open partial nephrectomy using preoperative fat density characteristics: preoperative fat characteristics for predicting ease of dissection at OPN. BJU Int 114:872–880. https://doi.org/10.1111/bju.12579

    Article  PubMed  Google Scholar 

  24. Ishiyama R, Kondo T, Takagi T et al (2018) Impact of the Mayo adhesive probability score on the complexity of robot-assisted partial nephrectomy. J Endourol 32:928–933. https://doi.org/10.1089/end.2017.0779

    Article  PubMed  Google Scholar 

  25. Borregales LD, Adibi M, Thomas AZ et al (2019) Predicting adherent perinephric fat using preoperative clinical and radiological factors in patients undergoing partial nephrectomy. EurUrol Focus. https://doi.org/10.1016/j.euf.2019.10.007

    Article  Google Scholar 

  26. Morrison A, Polisena J, Husereau D et al (2012) The effect of English-language restriction on systematic review-based meta-analyses: a systematic review of empirical studies. Int J Technol Assess Health Care 28:138–144. https://doi.org/10.1017/S0266462312000086

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

We would like to acknowledge Dr. Naoko Kawamura for responding to our emails and providing us with further information to accurately represent their work included in this meta-analysis.

Author information

Authors and Affiliations

  1. Department of Urology, Rennes University Hospital, Rennes, France

    Zine-Eddine Khene, Gilles Dosin, Benoit Peyronnet, Anis Gasmi, Marie Brassier, Romain Mathieu & Karim Bensalah

  2. Department of Urology and Renal Transplantation, Toulouse University Hospital, Toulouse, France

    Nicolas Doumerc & Mathieu Roumiguié

  3. Department of Urology, Bichat Hospital, APHP, Paris Diderot University, Paris, France

    Idir Ouzaid

  4. Department of Pathology, Rennes University Hospital, Rennes, France

    Nathalie Rioux-Leclercq

  5. Division of Urology, Penn State Health Milton S. Hershey Medical Center, Hershey, PA, USA

    Jay D. Raman

  6. Department of Urology, Medical University Vienna, General Hospital, Vienna, Austria

    Benjamin Pradere & Shahrokh Shariat

Authors
  1. Zine-Eddine Khene
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Gilles Dosin
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Benoit Peyronnet
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Anis Gasmi
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Nicolas Doumerc
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Idir Ouzaid
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Benjamin Pradere
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Marie Brassier
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Mathieu Roumiguié
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Romain Mathieu
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Nathalie Rioux-Leclercq
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Jay D. Raman
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. Shahrokh Shariat
    View author publications

    You can also search for this author in PubMed Google Scholar

  14. Karim Bensalah
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Zine-Eddine Khene.

Ethics declarations

Conflict of interest

No author has any conflict of interest.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary Information

Below is the link to the electronic supplementary material.

Supplementary file1 (DOCX 1777 KB)

Supplementary file2 (DOCX 2697 KB)

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Khene, ZE., Dosin, G., Peyronnet, B. et al. Adherent perinephric fat affects perioperative outcomes after partial nephrectomy: a systematic review and meta-analysis. Int J Clin Oncol 26, 636–646 (2021). https://doi.org/10.1007/s10147-021-01871-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10147-021-01871-6

Keywords

Search

Navigation