title: Visceral fat area as a new independent predictive factor of survival in patients with metastatic renal cell carcinoma treated with antiangiogenic agents.
abstract: Purpose. A better identification of patients who are more likely to benefit from vascular endothelial growth factor-targeted therapy is warranted in metastatic renal cell carcinoma (mRCC). As adipose tissue releases angiogenic factors, we determined whether parameters such as visceral fat area (VFA) were associated with outcome in these patients. Experimental Design. In 113 patients with mRCC who received antiangiogenic agents (bevacizumab, sunitinib, or sorafenib) (n = 64) or cytokines (n = 49) as first-line treatment, we used computed tomography to measure VFA and subcutaneous fat area (SFA). We evaluated associations linking body mass index (BMI), SFA, and VFA to time to progression (TTP) and overall survival (OS). Results. High SFA and VFA values were significantly associated with shorter TTP and OS. By multivariate analysis, high VFA was independently associated with shorter TTP and OS. These results were internally validated using bootstrap analysis. By contrast, VFA was not associated with survival in the cytokine group. In the whole population, interaction between VFA and treatment group was significant for TTP and OS, thereby confirming the results. Conclusion. Our study provides the first evidence that high VFA could be a predictive biomarker from shorter survival in patients given first-line antiangiogenic agents for mRCC.
authors.affiliation: Centre Georges François Leclerc, Centre de Recherche INSERM 866, Faculté de Médecine, 7 Boulevard Jeanne d'Arc, 21000 Dijon, France.
authors.forename: Sylvain
authors.initials: S
authors.lastname: Ladoire
authors.forename: Franck
authors.initials: F
authors.lastname: Bonnetain
authors.forename: Mélanie
authors.initials: M
authors.lastname: Gauthier
authors.forename: Sylvie
authors.initials: S
authors.lastname: Zanetta
authors.forename: Jean Michel
authors.initials: JM
authors.lastname: Petit
authors.forename: Séverine
authors.initials: S
authors.lastname: Guiu
authors.forename: Isabelle
authors.initials: I
authors.lastname: Kermarrec
authors.forename: Eric
authors.initials: E
authors.lastname: Mourey
authors.forename: Frederic
authors.initials: F
authors.lastname: Michel
authors.forename: Denis
authors.initials: D
authors.lastname: Krause
authors.forename: Patrick
authors.initials: P
authors.lastname: Hillon
authors.forename: Luc
authors.initials: L
authors.lastname: Cormier
authors.forename: François
authors.initials: F
authors.lastname: Ghiringhelli
authors.forename: Boris
authors.initials: B
authors.lastname: Guiu
mesh_terms: D000368:Aged; D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D002292:Carcinoma, Renal Cell / Q000098:blood supply* / Q000188:drug therapy* / Q000473:pathology; D015331:Cohort Studies; D018450:Disease Progression; D005260:Female; D006801:Humans; D050152:Intra-Abdominal Fat / Q000473:pathology*; D007680:Kidney Neoplasms / Q000098:blood supply* / Q000188:drug therapy* / Q000473:pathology; D008297:Male; D009362:Neoplasm Metastasis; D009389:Neovascularization, Pathologic / Q000188:drug therapy / Q000473:pathology; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D020533:Angiogenesis Inhibitors