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.
Keywords: Metastatic renal cell carcinoma; obesity; volumetric
body composition; prognosis