Department of Urology, Emory University School of Medicine, 1365 Clifton Road NE, Building B, Suite 1400, Atlanta, GA, 30322, USA.
Department of Radiology, Massachusetts General Hospital, Boston, MA, USA.
Curr Urol Rep. 2023 Jul;24(7):317-334. doi: 10.1007/s11934-023-01157-6. Epub 2023 Apr 10.
The purpose of this review is to provide an up-to-date understanding regarding the literature on sarcopenia and inflammation as prognostic factors in the context of renal cell carcinoma (RCC).
Sarcopenia is increasingly recognized as a prognostic factor in RCC. Emerging literature suggests monitoring quantity of muscle on successive imaging and examining muscle density may be additionally informative. Inflammation has prognostic ability in RCC and is also considered a key contributor to development and progression of both RCC and sarcopenia. Recent studies suggest these two prognostic factors together may provide additional prognostic ability when used in combination. Ongoing developments include quality control regarding sarcopenia research and imaging, improving understanding of muscle loss mechanisms, and enhancing clinical incorporation of sarcopenia via improving imaging analysis practicality (i.e., artificial intelligence) and feasible biomarkers. Sarcopenia and systemic inflammation are complementary prognostic factors for adverse outcomes in patients with RCC. Further study on high-quality sarcopenia assessment standardization and expedited sarcopenia assessment is desired for eventual routine clinical incorporation of these prognostic factors.
本综述旨在提供关于肌肉减少症和炎症作为肾细胞癌 (RCC) 预后因素的最新文献综述。
肌肉减少症越来越被认为是 RCC 的一个预后因素。新出现的文献表明,监测连续影像学上的肌肉量和检查肌肉密度可能会提供更多信息。炎症在 RCC 中有预后能力,并且也被认为是 RCC 和肌肉减少症发生和进展的关键因素。最近的研究表明,当这两个预后因素结合使用时,可能会提供额外的预后能力。正在进行的研究包括肌肉减少症研究和影像学的质量控制、提高对肌肉减少机制的理解以及通过提高影像学分析的实用性(即人工智能)和可行的生物标志物来增强肌肉减少症的临床应用。肌肉减少症和全身炎症是 RCC 患者不良预后的互补预后因素。需要进一步研究高质量的肌肉减少症评估标准化和加速的肌肉减少症评估,以便最终将这些预后因素常规纳入临床。