Department of Radiology, Charité, Berlin, Germany.
Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Berlin, Germany.
Ann Surg Oncol. 2023 Feb;30(2):1269-1276. doi: 10.1245/s10434-022-12738-z. Epub 2022 Nov 9.
To examine sex-specific differences in renal cell carcinoma (RCC) in relation to abdominal fat accumulation, psoas muscle density, tumor size, pathology, and survival, and to evaluate possible associations with RCC characteristics and outcome.
A total of 470 patients with RCC who underwent nephrectomy between 2006 and 2019 were included in this retrospective study. Specific characteristics of RCC patients were collected, including sex, height, tumor size, grade, and data on patient survival, if available. Abdominal fat measurements and psoas muscle area were determined at the level of L3 (cm).
Women had a higher subcutaneous (p < 0.001) and men had a higher visceral fat area, relative proportion of visceral fat area (p < 0.001), and psoas muscle index (p < 0.001). Logistic regression analysis showed an association between higher psoas muscle index and lower grade tumors [women: odds ratio (OR) 0.94, 95% confidence interval (CI) 0.89-0.99, p = 0.011; men: OR 0.97 (95% CI, 0.95-0.99, p = 0.012]. Univariate regression analysis demonstrated an association between psoas muscle index and overall survival (women: OR 1.41, 95% CI 1.03-1.93, p = 0.033; men: OR 1.62 (95% CI, 1.33-1.97, p < 0.001). In contrast, there were no associations between abdominal fat measurements and tumor size, grade, or survival. Also, there were no sex-specific differences in tumor size or tumor grades.
A higher preoperative psoas muscle index was independently associated with overall survival in RCC patients, with a stronger association in men compared with women. In addition, the psoas muscle index showed an inverse association with tumor grade, whereby this association was slightly more pronounced in women than in men.
研究肾细胞癌（RCC）患者的性别特异性差异与腹部脂肪堆积、腰大肌密度、肿瘤大小、病理和生存之间的关系，并评估其与 RCC 特征和预后的可能关联。
本回顾性研究纳入了 2006 年至 2019 年间接受肾切除术的 470 例 RCC 患者。收集了 RCC 患者的具体特征，包括性别、身高、肿瘤大小、分级以及患者生存数据（如有）。在 L3 水平测量腹部脂肪量和腰大肌面积（cm）。
女性的皮下脂肪（p < 0.001）和男性的内脏脂肪面积（p < 0.001）、内脏脂肪面积相对比例（p < 0.001）和腰大肌指数（p < 0.001）更高。Logistic 回归分析显示，较高的腰大肌指数与较低分级的肿瘤相关[女性：优势比（OR）0.94，95%置信区间（CI）0.89-0.99，p = 0.011；男性：OR 0.97（95%CI，0.95-0.99，p = 0.012]。单变量回归分析表明，腰大肌指数与总生存率相关（女性：OR 1.41，95%CI 1.03-1.93，p = 0.033；男性：OR 1.62（95%CI，1.33-1.97，p < 0.001）。相比之下，腹部脂肪测量值与肿瘤大小、分级或生存率之间无关联。此外，男女之间的肿瘤大小或肿瘤分级无明显差异。
术前较高的腰大肌指数与 RCC 患者的总生存率独立相关，且男性的相关性强于女性。此外，腰大肌指数与肿瘤分级呈负相关，女性的相关性略强于男性。
