Abdominal subcutaneous adipose tissue as a predictor of high-grade renal cell carcinoma

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