Visceral obesity in predicting oncologic outcomes of localized renal cell carcinoma.
OBJECTIVE
We investigate the clinicopathological features and prognostic significance of visceral obesity in patients with localized renal cell carcinoma.


METHODS
This study included 706 patients with localized renal cell carcinoma who had undergone curative surgery between January 2003 and April 2012. Visceral, subcutaneous and total adipose tissue were measured based on preoperative computerized tomography of the umbilical region. Visceral adipose tissue percent was calculated using the formula, VAT% = [visceral adipose tissue/total adipose tissue] × 100. The association between clinicopathological factors and visceral obesity was examined.


RESULTS
A higher VAT% at diagnosis was associated with older age at diagnosis, higher prevalence of diabetes and higher prevalence of former or current smoking status. The distribution of histological subtypes differed significantly among VAT% quartiles. The proportion of high grade tumors increased as VAT% increased (OR 1.023, 95% CI 1.000-1.126, p = 0.037). A U-shaped association between VAT% quartiles and the risk of disease recurrence was observed for all patients. Disease recurrence was significantly increased in the lowest (HR 3.198, 95% CI 1.765-10.040, p = 0.036) and highest (HR 4.760, 95% CI 2.937-13.210, p = 0.010) VAT% quartiles.


CONCLUSIONS
Relative visceral obesity as assessed by VAT% was associated with clinicopathological characteristics of localized renal cell carcinoma. A U-shaped association between VAT% quartiles and risk of disease recurrence was observed among patients with localized renal cell carcinoma.
Department of Urology, Seoul National University Bundang Hospital, Seongnam and College of Medicine, Seoul National University, Seoul, Korea.
Yong Hyun
YH
Park
Department of Urology, Seoul National University Bundang Hospital, Seongnam and College of Medicine, Seoul National University, Seoul, Korea.
Jeong Keun
JK
Lee
Department of Urology, Seoul National University Bundang Hospital, Seongnam and College of Medicine, Seoul National University, Seoul, Korea.
Kwang Mo
KM
Kim
Department of Urology, Seoul National University Bundang Hospital, Seongnam and College of Medicine, Seoul National University, Seoul, Korea.
Ha Rim
HR
Kook
Department of Urology, Seoul National University Bundang Hospital, Seongnam and College of Medicine, Seoul National University, Seoul, Korea.
Hansol
H
Lee
Department of Urology, Seoul National University Bundang Hospital, Seongnam and College of Medicine, Seoul National University, Seoul, Korea.
Ki Bum
KB
Kim
Department of Urology, Seoul National University Bundang Hospital, Seongnam and College of Medicine, Seoul National University, Seoul, Korea.
Sangchul
S
Lee
Department of Urology, Seoul National University Bundang Hospital, Seongnam and College of Medicine, Seoul National University, Seoul, Korea.
Seok-Soo
SS
Byun
Department of Urology, Seoul National University Bundang Hospital, Seongnam and College of Medicine, Seoul National University, Seoul, Korea. Electronic address: selee@snubh.org.
Sang Eun
SE
Lee
D000328:Adult; D015992:Body Mass Index; D002292:Carcinoma, Renal Cell / Q000150:complications* / Q000401:mortality / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D050152:Intra-Abdominal Fat / Q000473:pathology; D007680:Kidney Neoplasms / Q000150:complications* / Q000401:mortality / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology; D009392:Nephrectomy; D056128:Obesity, Abdominal / Q000150:complications* / Q000175:diagnosis; D011379:Prognosis; D056910:Republic of Korea / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate / Q000639:trends; D014057:Tomography, X-Ray Computed
adipose tissue; carcinoma; intra-abdominal fat; prognosis; renal cell