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Impact of baseline visceral fat accumulation on prognosis in patients with metastatic renal cell carcinoma treated with systemic therapy

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Abstract

The aim of this study was to evaluate the clinical significance of visceral fat accumulation as a prognostic factor in patients with metastatic renal cell carcinoma (mRCC) treated with systemic therapies. A total of 114 patients were retrospectively reviewed. All patients received systemic therapy for mRCC at Keio University hospital in Japan. The intra-abdominal visceral fat area was determined by computed tomography at the umbilical level. The visceral fat accumulation was defined as ≥100 cm2. The mean visceral fat area was 107.4 ± 62.8 cm2. In the whole cohort, the median follow-up was 29 months. According to the Memorial Sloan Kettering Cancer Center (MSKCC) classification, 27.2% patients were favorable risk, 53.5% were intermediate risk, and 19.3% were poor risk. Visceral fat accumulation correlated with improved progression-free (P = 0.0070) and overall survival (P = 0.0001). On multivariate analysis, visceral fat accumulation (P = 0.0290) and MSKCC classification (P = 0.0085) were independent indices to predict progression-free survival in first-line treatment. In addition, visceral fat accumulation (P = 0.0007) and MSKCC classification (P = 0.0005) independently predicted overall survival. Prognostic grouping using visceral fat accumulation was identified as an independent prognostic marker in patients with mRCC. The addition of visceral fat accumulation improved the prognostic value of MSKCC classification alone in predicting overall survival in patients treated with systemic therapy for mRCC.

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Authors and Affiliations

  1. Department of Urology, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku, Tokyo, 160-8582, Japan

    Ryuichi Mizuno, Akira Miyajima, Taizo Hibi, Aya Masuda, Toshiaki Shinojima, Eiji Kikuchi, Masahiro Jinzaki & Mototsugu Oya

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  1. Ryuichi Mizuno
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  2. Akira Miyajima
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  3. Taizo Hibi
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  4. Aya Masuda
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  5. Toshiaki Shinojima
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  6. Eiji Kikuchi
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  7. Masahiro Jinzaki
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  8. Mototsugu Oya
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Corresponding author

Correspondence to Ryuichi Mizuno.

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Conflict of interest

Ryuichi Mizuno MD has received honoraria from Novartis and Pfizer. Mototsugu Oya MD has received honoraria from Bayer, Novartis, and Pfizer. Other authors declare that they have no conflict of interest.

Ethical standards

All procedures performed in studies involving human participants were in accordance with the ethical standards of Keio University Research Ethics Committee https://www.ccr.med.keio.ac.jp/rinri/top.php (Approval No-20130424) and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Mizuno, R., Miyajima, A., Hibi, T. et al. Impact of baseline visceral fat accumulation on prognosis in patients with metastatic renal cell carcinoma treated with systemic therapy. Med Oncol 34, 47 (2017). https://doi.org/10.1007/s12032-017-0908-3

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  • DOI: https://doi.org/10.1007/s12032-017-0908-3

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