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Volumetric body composition parameters in predicting survival outcomes of metastatic renal cell carcinoma patients treated with targeted therapy
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  • Oktay Aktepe,
  • Ahmet Gürkan Erdemir,
  • Gurkan Guner,
  • Deniz Can Güven,
  • Suayib Yalcin,
  • Mehmet Ruhi Onur,
  • Mustafa Erman
Oktay Aktepe
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Ahmet Gürkan Erdemir
Hacettepe University Faculty of Medicine
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Gurkan Guner
Hacettepe University
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Deniz Can Güven
Hacettepe University
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Suayib Yalcin
Hacettepe University
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Mehmet Ruhi Onur
Hacettepe University
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Mustafa Erman
Hacettepe University
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Abstract

Background: To explore the clinical significance of baseline volumetric body composition parameters evaluated with computerized tomography (CT) and their changes after 3-4 months from treatment initiation of targeted therapy in patients with metastatic renal cell carcinoma (mRCC). Method: This study included 108 Caucasian mRCC patients (Male/Female: 77/31) treated with targeted therapy. Volumetric body composition parameters including total adipose tissue index (TATI), subcutaneous adipose tissue index (SATI), visceral adipose tissue index (VATI) and skeletal muscle index (SMI) values were depicted from CT images at third lumbar vertebra level through volumetric measurement software. Kaplan-Meier method and the long test were used for estimation of progression free survival (PFS) and overall survival (OS). Univariate and multivariate analyses were done to determine the associations between clinic-pathologic variables including VBC and survival outcomes. Results: The median PFS and OS of all patients were 11 months and 46 months in patients respectively. After adjustment for the variables including international mRCC database consortium (IMDC) risk score, only a high skeletal muscle index (SMI) was associated with better PFS (HR: 0.975, P=0.015). The independent predictors for OS were VATI (HR 1.005, P=0.024), SATI (HR: 0.976, P=0.019) and TATI (HR: 0.982, P=0.035) in addition to IMDC risk score. Conclusion: Our findings revealed that while SMI was the only significant determinant parameter for PFS among VBC parameters, TATI, VATI, and SATI were determined as independent predictors for OS in addition to IMDC risk score.

Peer review status:UNDER REVIEW

24 Apr 2021Submitted to International Journal of Clinical Practice
24 Apr 2021Assigned to Editor
24 Apr 2021Submission Checks Completed
01 May 2021Reviewer(s) Assigned
15 May 2021Review(s) Completed, Editorial Evaluation Pending