Department of Urology, Bishan Hospital of Chongqing Medical University, Chongqing, China.
Department of Urology, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Urol Oncol. 2023 May;41(5):257.e19-257.e26. doi: 10.1016/j.urolonc.2023.01.023. Epub 2023 Mar 24.
To assess the effects of metabolic syndrome (MetS) and its components on the survival and prognosis of patients with localized clear cell renal cell carcinoma (ccRCC).
This retrospective cohort study in Chongqing, China, identified patients with localized ccRCC from two medical centers of Chongqing Medical University between January 1, 2011, and December 31, 2020. The Chinese Medical Association Diabetes Society criteria of 2004 were used to diagnose MetS. Univariate and multivariate Cox proportional hazards regression analyses were conducted to identify independent risk factors for ccRCC. The outcomes were overall survival (OS), progression-free survival (PFS), and cancer-specific survival (CSS).
In our cohort, 378 eligible patients with localized ccRCC were included (median age, 56; range, 30-85; 255 men [67.5%]), and 87 patients (23.0%) were diagnosed with MetS. The median follow-up time was 66 months (1-126 months). Kaplan-Meier and log-rank analyses showed shorter PFS (P = 0.043) and CSS (P = 0.009) in patients with MetS. Univariate and multivariate Cox regression analyses found that MetS and dyslipidemia were independent risk factors for CSS in patients with localized ccRCC (P = 0.047; P = 0.035). When we analyzed MetS separately, the 4 components of MetS (hypertension, hyperglycemia, overweight/obesity, and dyslipidemia) did not show significant differences in OS, PFS, and CSS.
MetS and dyslipidemia are independent adverse prognostic factors for CSS in patients with localized ccRCC. It is suggested to assign comprehensive therapy and follow-up to this patient population.
评估代谢综合征（MetS）及其各组分对局限性透明细胞肾细胞癌（ccRCC）患者生存和预后的影响。
这是一项在中国重庆进行的回顾性队列研究，纳入了 2011 年 1 月 1 日至 2020 年 12 月 31 日期间重庆医科大学两所医学中心的局限性 ccRCC 患者。采用 2004 年中华医学会糖尿病学分会的标准诊断 MetS。采用单因素和多因素 Cox 比例风险回归分析来确定 ccRCC 的独立危险因素。结局指标为总生存（OS）、无进展生存（PFS）和癌症特异性生存（CSS）。
在我们的队列中，纳入了 378 例符合条件的局限性 ccRCC 患者（中位年龄为 56 岁，范围为 30-85 岁；255 例男性[67.5%]），87 例（23.0%）患者诊断为 MetS。中位随访时间为 66 个月（1-126 个月）。Kaplan-Meier 生存曲线和 log-rank 检验显示，MetS 患者的 PFS（P=0.043）和 CSS（P=0.009）较短。单因素和多因素 Cox 回归分析发现，MetS 和血脂异常是局限性 ccRCC 患者 CSS 的独立危险因素（P=0.047；P=0.035）。当我们分别分析 MetS 时，MetS 的 4 个组分（高血压、高血糖、超重/肥胖和血脂异常）在 OS、PFS 和 CSS 方面均无显著差异。
MetS 和血脂异常是局限性 ccRCC 患者 CSS 的独立不良预后因素。建议对这一患者群体进行综合治疗和随访。
