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

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 cm. The mean visceral fat area was 107.4 ± 62.8 cm. 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.