Perirenal fat in surgically treated renal cell carcinoma tied to increased mortality risk: Study

China: In surgically treated clear cell renal cell carcinoma (RCC), a higher percentage of perirenal adipose tissue is related to increased mortality risk, says an article published in the journal Clinical Genitourinary Cancer on 20th October 2021.

After complete resection of the main tumor, approximately 20% of patients with renal cell carcinoma present with predominantly metastatic disease, and over 30% of patients with localized RCC will acquire distant metastases later. Accurate postoperative prognostic models are necessary for developing tailored surveillance programmes as well as adjuvant therapy and clinical trials. Obesity has recently been linked to the development and prognosis of renal cell carcinoma, according to growing data. Therefore, Yiqing Du and colleagues undertook this study to see if there was a link between various obesity parameters and overall survival in patients with surgically treated clear cell renal cell carcinoma.

From January 2009 to November 2014, the data of 342 patients who underwent radical or partial nephrectomy at Peking University People's Hospital were evaluated retrospectively. The average period of follow-up was 82 months. The Kaplan-Meier technique and Cox regression models were used to assess the relationship between different obesity measurements and overall survival.

The results of this study stated as follow:

1. Perirenal fat accumulation, as well as age, sex, clinical presentation, surgical option, tumor size, and grade, were all linked with overall survival in univariate Cox regression analysis.

2. Other obesity parameters, such as BMI, waist circumference, total adipose tissue, visceral adipose tissue, and visceral adipose tissue percentage, were not evaluated as predictive markers of overall survival in this study.

3. Despite controlling for age, gender, clinical manifestations, surgical choice, tumor size, T stage, and tumor grade, perirenal fat accumulation was found to be an independent predictor of overall survival.

4. Patients with a larger amount of perirenal fat had a lower overall survival rate, according to the results of the Kaplan-Meier model.

Reference: 

Du Y, Yang W, Liu H, Qin C, Tang X, Xu T. Perirenal Fat as a New Independent Prognostic Factor in Patients With Surgically Treated Clear Cell Renal Cell Carcinoma. Clin Genitourin Cancer. 2022 Feb;20(1):e75-e80. doi:10.1016/j.clgc.2021.10.006. Epub 2021 Oct 20. PMID: 34802967.