Abstract
BACKGROUND: information about the influence of abdominal adipose tissue on the prognosis and aggressiveness of renal cell carcinoma is scarce.OBJECTIVE: to identify and quantify the relationship between abdominal adipose tissue and histopathologic characteristics of renal cell carcinoma.MATERIALS AND METHODS: data on patients with renal cell carcinoma treated with partial or radical nephrectomy were retrospectively collected. Visceral adipose tissue and subcutaneous adipose tissue were measured on preoperative computerized tomography scans. Histopathologic (pathologic 2002 TNM classification, tumor size, nuclear grade, necrosis, and metastasis) and clinical (sex, age, body mass index) variables were assessed. Visceral adipose tissue and subcutaneous adipose tissue were adjusted by patient height (VAT-I and SAT-I). The association between adipose tissue measurements, patient characteristics, and histopathologic variables was assessed through a correlation, comparison, and regression analysis. A survival analysis was also carried out.RESULTS: one-hundred and five patients were included. No significant relationship between visceral adipose tissue and histopathologic characteristics was found. SAT-I was a significant variable inversely related to sex, but more importantly to nuclear grade, pN+, and necrosis. There was no influence of visceral adipose tissue or subcutaneous adipose tissue on survival.CONCLUSIONS: subcutaneous adipose tissue was related to the histopathologic characteristics of renal cell carcinoma. A larger amount of subcutaneous adipose tissue predicted a low nuclear grade and a lower frequency of pN+ and necrosis. Further study to clarify the interaction between adipose tissue and renal cell carcinoma biology is required.KEY WORDS: renal cell carcinoma, subcutaneous-abdominal adipose tissue, prognosis
Highlights
100,000 new cases of renal cell carcinoma are reported in the U.S and Europe each year [1]
We have previously evaluated the reliability of computed tomography (CT) to predict nuclear grade in renal cell carcinoma [8]
subcutaneous adipose tissue (SAT)-I was selected as the candidate variable due to its significant and coherent relationship with the histopathologic characteristics of renal cell carcinoma
Summary
100,000 new cases of renal cell carcinoma are reported in the U.S and Europe each year [1]. Several risk factors, such as smoking, hypertension, occupational exposure, and family history have been related to this disease [2]. Several attempts to identify risk factors of tumor aggressiveness have been pursued. Since angiogenesis is a key factor in the development of renal cell carcinoma, molecular targeted therapy, including Vascular Endothelial Growth Factor inhibition, has become a standard of care for advanced renal cell carcinoma [3]. Adipogenesis and adipocytes are related to neovascularization of tumors, as they have common paracrine signaling pathways. Adipogenesis should be related to tumor angiogenesis
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