Du Yiqing, Yang Wenbo, Liu Huixin, Qin Caipeng, Tang Xu, Xu Tao
Department of Urology, Peking University People's Hospital, Beijing 100044, China.
Department of Clinical Epidemiology, Peking University People's Hospital, Beijing 100044, China.
Clin Genitourin Cancer. 2022 Feb;20(1):e75-e80. doi: 10.1016/j.clgc.2021.10.006. Epub 2021 Oct 20.
Recently increasing evidence has suggested that obesity is associated with the development and prognosis of renal cell carcinoma. The aim of the study was to investigate the association between different obesity measurements and overall survival in patients with surgically treated clear cell renal cell carcinoma.
The data of 342 consecutive patients who underwent radical or partial nephrectomy at Peking University People's Hospital from January 2009 to November 2014 were retrospectively reviewed. Median follow-up was 82 months. The association between different obesity measurements and overall survival was evaluated using the Kaplan-Meier method and Cox regression models.
In univariate Cox regression analyses, perirenal fat accumulation was significantly associated with overall survival (HR: 2.271; 95% CI: 1.311-3.935; P = .003), as well as age, sex, clinical manifestation, surgical option, tumor size, and grade. The other obesity measurements, including body mass index, waist circumference, total adipose tissue, visceral adipose tissue, and percentage of visceral adipose tissue, were not assessed as prognostic indicators of overall survival in this study (P > .05). After adjusting for age, sex, clinical manifestation, surgical option, tumor size, T stage, and tumor grade, perirenal fat accumulation was still identified as an independent predictor of overall survival (HR: 2.264; 95% CI: 1.305-3.926; P == .004). The results of Kaplan-Meier model also revealing that patients with higher percentage of perirenal fat showed poorer overall survival (P == .003).
Higher percentage of perirenal adipose tissue is independently associated with increased mortality risk in surgically treated clear cell renal cell carcinoma.
最近越来越多的证据表明，肥胖与肾细胞癌的发生发展及预后相关。本研究旨在探讨不同肥胖测量指标与接受手术治疗的透明细胞肾细胞癌患者总生存期之间的关联。
回顾性分析2009年1月至2014年11月在北京大学人民医院接受根治性或部分肾切除术的342例连续患者的数据。中位随访时间为82个月。采用Kaplan-Meier法和Cox回归模型评估不同肥胖测量指标与总生存期之间的关联。
在单因素Cox回归分析中，肾周脂肪堆积与总生存期显著相关（HR：2.271；95%CI：1.311-3.935；P = .003），同时还与年龄、性别、临床表现、手术方式、肿瘤大小及分级相关。本研究未将其他肥胖测量指标，包括体重指数、腰围、总脂肪组织、内脏脂肪组织及内脏脂肪组织百分比评估为总生存期的预后指标（P > .05）。在调整年龄、性别、临床表现、手术方式、肿瘤大小、T分期及肿瘤分级后，肾周脂肪堆积仍被确定为总生存期的独立预测因素（HR：2.264；95%CI：1.305-3.926；P = .004）。Kaplan-Meier模型结果也显示，肾周脂肪百分比越高的患者总生存期越差（P = .003）。
在接受手术治疗的透明细胞肾细胞癌患者中，较高的肾周脂肪组织百分比与死亡风险增加独立相关。
