Tang Huancheng, Xie Ye, Yang Ling, Zhang Lihao, Fu Qiao, Huang Yixin, Huang Tingxuan, Wen Dongxiang, Ye Baokui, Yang Xiaofeng, Zhang Zhiling, Zhou Fangjian, Peng Yulu, Zhang Wei
Department of Urology, Wuhan Third Hospital, Tongren Hospital of Wuhan University, Wuhan, China.
Department of Urology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.
Sci Rep. 2025 Sep 2;15(1):32341. doi: 10.1038/s41598-025-17865-7.
Renal cell carcinoma accounts for a significant number of kidney malignancy-related fatalities globally. Perirenal Fat Thickness (PRFT) may indicate a state of nutritional excess in patients, which is potentially directly linked to both the incidence and prognosis of kidney cancer. This study investigated the association between perirenal fat thickness (PRFT) and overall survival (OS), as well as the predictive value of PRFT for postoperative estimated glomerular filtration rate (eGFR) in patients with renal cell carcinoma (RCC). A retrospective cohort of 1647 RCC patients from 2014 to 2021 was analyzed, divided into radical nephrectomy (RN) and partial nephrectomy (PN) groups. Preoperative measurements included visceral fat area, PRFT, and subcutaneous fat area. Kaplan-Meier curves compared OS between high and low PRFT groups, while Cox regression analyses identified prognostic factors for OS, and linear regression analyses assessed predictors of postoperative eGFR. PRFT significantly influenced OS in RN patients in univariate analysis (HR: 0.32; 95% CI: 0.19-0.52; P < 0.001), but not in PN patients. After adjusting for covariates such as age, sex, sarcomatoid features, necrosis, T stage, Fuhrman grade, smoking status, subcutaneous adipose tissue, and BMI, PRFT remained an independent risk factor for OS (HR: 0.56; 95% CI: 0.33-0.96; P < 0.001). Kaplan-Meier analysis showed that higher PRFT was associated with improved OS in RN patients. Univariate linear regression revealed that high PRFT correlated with reduced postoperative eGFR in both RN (β = -0.2, P = 0.002) and PN (β = -0.34, P < 0.001) groups; however, this correlation was not significant after multivariate adjustment. In conclusion, Low PRFT is independently associated with higher mortality in RCC patients undergoing RN. High PRFT is associated with reduced postoperative eGFR in initial analyses, but this association was not significant in multivariate analysis.
在全球范围内，肾细胞癌导致了大量与肾脏恶性肿瘤相关的死亡。肾周脂肪厚度（PRFT）可能表明患者存在营养过剩状态，这可能与肾癌的发病率和预后直接相关。本研究调查了肾周脂肪厚度（PRFT）与总生存期（OS）之间的关联，以及PRFT对肾细胞癌（RCC）患者术后估计肾小球滤过率（eGFR）的预测价值。对2014年至2021年的1647例RCC患者的回顾性队列进行了分析，分为根治性肾切除术（RN）和部分肾切除术（PN）组。术前测量包括内脏脂肪面积、PRFT和皮下脂肪面积。Kaplan-Meier曲线比较了高PRFT组和低PRFT组的OS，Cox回归分析确定了OS的预后因素，线性回归分析评估了术后eGFR的预测因素。在单因素分析中，PRFT对RN患者的OS有显著影响（HR：0.32；95%CI：0.19-0.52；P＜0.001），但对PN患者无影响。在调整年龄、性别、肉瘤样特征、坏死、T分期、Fuhrman分级、吸烟状态、皮下脂肪组织和BMI等协变量后，PRFT仍然是OS的独立危险因素（HR：0.56；95%CI：0.33-0.96；P＜0.001）。Kaplan-Meier分析表明，较高的PRFT与RN患者的OS改善相关。单因素线性回归显示，高PRFT与RN组（β = -0.2，P = 0.002）和PN组（β = -0.34，P＜0.001）术后eGFR降低相关；然而，在多因素调整后，这种相关性不显著。总之，低PRFT与接受RN的RCC患者较高的死亡率独立相关。在初始分析中，高PRFT与术后eGFR降低相关，但在多因素分析中这种相关性不显著。
