Department of Urology, Seoul National University Hospital, Seoul, Korea.
Department of Urology, Chonnam National University Hwasun Hospital, Hwasun, Korea.
Sci Rep. 2020 Apr 24;10(1):6967. doi: 10.1038/s41598-020-63816-9.
The effect of metabolic characteristics on the prognosis of patients with metastatic renal cell carcinoma remains controversial. We investigated the associations between metabolic features of each individual and disease prognosis in patients with metastatic renal cell carcinoma. Data of 1,584 patients with metastatic renal cell carcinoma from a multi-institutional database were retrospectively analyzed. The entire cohort was stratified into three subgroups according to how many patients had abnormal metabolic features (hypertension, diabetes mellitus, and low body mass index). The Kaplan-Meier and Cox proportional analyses were performed to investigate the associations between abnormal metabolic features and disease prognosis. mThere were 465 subjects without any metabolic features, 995 with one or two, and 124 with three. When the survival outcomes were compared according to the number of metabolic features, patients with higher numbers of metabolic features had significantly shorter overall and cancer-specific survival than those with fewer metabolic features (all p values <0.05). The multivariate Cox analysis showed that the number of metabolic features was an independent predictor for shorter cancer-specific and overall survival (all p values < 0.05). When performing subgroup analysis according to the cellular type, significant results were only obtained among the clear cell subtype subgroup, with the association not being significant in the non-clear cell subtype cohort. Patients with more metabolic features had significantly worse survival outcomes than those with fewer metabolic features. However, the association was only statistically significant in patients with clear cell-type metastatic renal cell carcinoma.
代谢特征对转移性肾细胞癌患者预后的影响仍存在争议。我们研究了每个患者的代谢特征与转移性肾细胞癌患者疾病预后之间的关系。回顾性分析了来自多机构数据库的 1584 名转移性肾细胞癌患者的数据。根据代谢特征异常的患者数量（高血压、糖尿病和低体重指数），将整个队列分为三组。采用 Kaplan-Meier 和 Cox 比例分析方法，研究代谢特征异常与疾病预后之间的关系。无任何代谢特征的患者有 465 例，有 1 种或 2 种代谢特征的患者有 995 例，有 3 种代谢特征的患者有 124 例。根据代谢特征的数量比较生存结果时，具有更多代谢特征的患者的总生存期和癌症特异性生存期明显短于具有较少代谢特征的患者（所有 p 值均<0.05）。多变量 Cox 分析显示，代谢特征的数量是癌症特异性和总生存期较短的独立预测因子（所有 p 值均<0.05）。根据细胞类型进行亚组分析时，仅在透明细胞亚型亚组中获得了显著结果，而非透明细胞亚型队列中无显著相关性。具有更多代谢特征的患者的生存结局明显差于具有较少代谢特征的患者。然而，这种关联仅在透明细胞型转移性肾细胞癌患者中具有统计学意义。
