MP47-14 THE ROLE OF COMBINED SARCOPENIA AND ALBUMIN IN THE SURGICAL PROGNOSTICATION OF LOCALLY ADVANCED RENAL CELL CARCINOMA WITH VENOUS TUMOR THROMBUS

Abstract

You have accessJournal of UrologyCME1 May 2022MP47-14 THE ROLE OF COMBINED SARCOPENIA AND ALBUMIN IN THE SURGICAL PROGNOSTICATION OF LOCALLY ADVANCED RENAL CELL CARCINOMA WITH VENOUS TUMOR THROMBUS Eric Midenberg, Dattatraya Patil, Alexandra Medline, Michelle Higgins, Milton Williams, Sarah P. Psutka, Kenneth Ogan, Mehmet A. Bilen, and Viraj A. Master Eric MidenbergEric Midenberg More articles by this author , Dattatraya PatilDattatraya Patil More articles by this author , Alexandra MedlineAlexandra Medline More articles by this author , Michelle HigginsMichelle Higgins More articles by this author , Milton WilliamsMilton Williams More articles by this author , Sarah P. PsutkaSarah P. Psutka More articles by this author , Kenneth OganKenneth Ogan More articles by this author , Mehmet A. BilenMehmet A. Bilen More articles by this author , and Viraj A. MasterViraj A. Master More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002618.14AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Baseline evaluation of skeletal muscle index (SMI; cm2/m2) and serum albumin have demonstrated value in the preoperative risk assessment of patients with renal cell carcinoma (RCC). We hypothesize that sarcopenia, defined as a critical deficiency in skeletal muscle mass, and hypoalbuminemia will be associated with decreased overall survival (OS) and cancer specific survival (CSS) in nonmetastatic RCC patients undergoing radical nephrectomy and tumor thrombectomy. METHODS: We retrospectively analyzed 103 nonmetastatic RCC patients who underwent radical nephrectomy and tumor thrombectomy from 2005 to 2020. Optimally fit body mass index (BMI; kg/m2) and sex-stratified sarcopenia thresholds were calculated: BMI<30, SMI <47 for males and SMI <38 for females; BMI≥30, SMI<54 for males and SMI <47 for females. Sarcopenia and albumin risk groups were created based on their individual hazard ratios in univariable analysis and defined as low-risk (non-sarcopenic, normal albumin), medium-risk (hypoalbuminemia only), high-risk (sarcopenia only), and very high-risk (sarcopenia, hypoalbuminemia). Multivariable and Kaplan-Meier analyses were used to determine associations between independent and combined sarcopenia and hypoalbuminemia (albumin <3.5 g/dL) with OS and CSS. RESULTS: Preoperatively, 51.2% and 44.7% of our cohort had sarcopenia and hypoalbuminemia, respectively. In the independent multivariable analysis, sarcopenia was significantly associated with decreased OS (p=0.003) and CSS (p=0.006) whereas no relationship between hypoalbuminemia and OS and CSS was found (OS: p=0.096; CSS: p=0.718). In a separate model analyzing the combined sarcopenia and albumin risk groups, the high and very high-risk groups were significantly associated with decreased OS (high-risk: p=0.011; very high-risk: p <0.001) and CSS (high-risk: p=0.011; very high-risk: p=0.017). Kaplan-Meier curves showed a stepwise decline in median OS (p=0.007) and CSS (p=0.007) times with increasing risk. CONCLUSIONS: Simultaneous preoperative sarcopenia and hypoalbuminemia conveyed nearly a seven-fold decrease in OS and CSS in patients undergoing surgery for nonmetastatic RCC with venous tumor thrombus. Source of Funding: N/A © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e815 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Eric Midenberg More articles by this author Dattatraya Patil More articles by this author Alexandra Medline More articles by this author Michelle Higgins More articles by this author Milton Williams More articles by this author Sarah P. Psutka More articles by this author Kenneth Ogan More articles by this author Mehmet A. Bilen More articles by this author Viraj A. Master More articles by this author Expand All Advertisement PDF DownloadLoading ...