Makino Tomoyuki, Izumi Kouji, Iwamoto Hiroaki, Kadomoto Suguru, Mizokami Atsushi
Department of Integrative Cancer Therapy and Urology, Kanazawa University Graduate School of Medical Science, 13-1 Takara-Machi, Kanazawa 920-8640, Japan.
Biomedicines. 2023 Jun 1;11(6):1604. doi: 10.3390/biomedicines11061604.
The purpose of this study is to observe how preoperative sarcopenia and hypoalbuminemia affect the oncological outcome of nonmetastatic renal cell carcinoma (RCC) after partial or radical nephrectomy.
This study retrospectively analyzes 288 Japanese patients with nonmetastatic RCC who underwent radical treatment at Kanazawa University Hospital between October 2007 and December 2018. Relationships between sarcopenia as indicated by the psoas muscle mass index and hypoalbuminemia (albumin ≤ 3.5 g/dL) with overall survival (OS) and metastasis-free survival (MFS) were determined.
The study found that 110 (38.2%) of the 288 patients were sarcopenic and 29 (10.1%) had hypoalbuminemia. The combination of sarcopenia and hypoalbuminemia was associated with a shorter OS and MFS ( for trend = 0.0007 and <0.0001, respectively), according to Kaplan-Meier curves. The concurrent presence of sarcopenia and hypoalbuminemia were found to be significant and independent predictors of poor MFS (hazard ratio (HR), 2.96; 95% confidence interval (95% CI), 1.05-8.39; = 0.041) and poor OS (HR, 6.87; 95% CI, 1.75-26.94; = 0.006), respectively.
In Japanese patients with surgically treated nonmetastatic RCC, combined preoperative sarcopenia and hypoalbuminemia was a significant predictor of poor survival.
本研究旨在观察术前肌肉减少症和低蛋白血症如何影响部分或根治性肾切除术后非转移性肾细胞癌（RCC）的肿瘤学结局。
本研究回顾性分析了2007年10月至2018年12月期间在金泽大学医院接受根治性治疗的288例日本非转移性RCC患者。确定腰大肌质量指数所表明的肌肉减少症和低蛋白血症（白蛋白≤3.5 g/dL）与总生存期（OS）和无转移生存期（MFS）之间的关系。
研究发现，288例患者中有110例（38.2%）存在肌肉减少症，29例（10.1%）存在低蛋白血症。根据Kaplan-Meier曲线，肌肉减少症和低蛋白血症的组合与较短的OS和MFS相关（趋势检验P值分别为0.0007和<0.0001）。肌肉减少症和低蛋白血症同时存在被发现是MFS差（风险比（HR），2.96；95%置信区间（95%CI），1.05 - 8.39；P = 0.041）和OS差（HR，6.87；95%CI，1.75 - 26.94；P = 0.006）的显著且独立预测因素。
在接受手术治疗的日本非转移性RCC患者中，术前肌肉减少症和低蛋白血症并存是生存不良的重要预测因素。
