Impact of baseline visceral fat accumulation on prognosis in patients with metastatic renal cell carcinoma treated with systemic therapy

2017 ◽  
Vol 34 (4) ◽  
Author(s):  
Ryuichi Mizuno ◽  
Akira Miyajima ◽  
Taizo Hibi ◽  
Aya Masuda ◽  
Toshiaki Shinojima ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Metastatic Renal Cell Carcinoma ◽  
Systemic Therapy ◽  
Visceral Fat ◽  
Renal Cell ◽  
Fat Accumulation ◽  
Visceral Fat Accumulation

Visceral fat accumulation is associated with different pathological subtypes of renal cell carcinoma (RCC): a multicentre study in China

2014 ◽  
Vol 114 (4) ◽  
pp. 496-502 ◽  
Author(s):  
Hong-Kai Wang ◽  
Xi-Shuang Song ◽  
Yue Cheng ◽  
Yuan-Yuan Qu ◽  
Shi-Lin Zhang ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Multicentre Study ◽  
Cell Carcinoma ◽  
Visceral Fat ◽  
Renal Cell ◽  
Fat Accumulation ◽  
Visceral Fat Accumulation ◽  
Pathological Subtypes

Impact of precise quantitative assessment of visceral obesity on outcomes of patients with metastatic renal cell carcinoma treated with systemic therapy.

2016 ◽  
Vol 34 (2_suppl) ◽  
pp. 597-597
Author(s):  
Ryuichi Mizuno ◽  
Akira Miyajima ◽  
Nozomi Hayakawa ◽  
Eiji Kikuchi ◽  
Shuji Mikami ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Overall Survival ◽  
Cell Carcinoma ◽  
Metastatic Renal Cell Carcinoma ◽  
Systemic Therapy ◽  
Visceral Fat ◽  
Renal Cell ◽  
Visceral Obesity ◽  
Cancer Center ◽  
Visceral Fat Area

597 Background: With its excellent resolution of adipose tissue, CT presents precise quantitative assessment of visceral obesity. We assessed the impact of visceral obesity on progression free and overall survival in patients treated with systemic therapy for metastatic renal cell carcinoma. Methods: This retrospective cohort study included 114 patients treated with systemic therapy for metastatic renal cell carcinoma between 2007 and 2015 at Keio university hospital in Japan. The visceral fat area was measured at the level of umbilicus using CT. A visceral fat area ≥100cm2 was used as the definition of visceral obesity. Progression free and overall survival was compared according to visceral obesity. Results: In the whole cohort, the median progression free survival in first line treatment was 12.0 month. The median overall survival was 42.5 month. According to Memorial Sloan-Kettering Cancer Center classification, 31 patients were favorable risk, 61 were intermediate risk, and 22 were poor risk; median overall survival for these groups were 76.9, 40.8, and 23.7 months, respectively (P<0.0001). Visceral obesity correlated with improved progression free (P=0.0095) and overall survival (P=0.0002). On multivariate analysis, visceral obesity (HR 0.64, P=0.0393) and Memorial Sloan-Kettering Cancer Center classification (P=0.0037) were independent indices to predict progression free survival in first line treatment. In addition, visceral obesity (HR 0.42, P=0.0016) and Memorial Sloan-Kettering Cancer Center classification (P=0.0006) independently predicted overall survival. Conclusions: The precision of CT imaging for measuring visceral fat tissue provides useful clinical venue to predict prognosis for metastatic renal cell carcinoma. Visceral obesity may be a useful and independent indicator for a better prognosis in patients treated with systemic therapy for metastatic renal cell carcinoma.

scholarly journals Optimizing systemic therapy for metastatic renal cell carcinoma beyond the first-line setting

2015 ◽  
Vol 33 (12) ◽  
pp. 538-545 ◽  
Author(s):  
Guillermo de Velasco ◽  
Lana Hamieh ◽  
Suzanne Mickey ◽  
Toni K. Choueiri
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Metastatic Renal Cell Carcinoma ◽  
Systemic Therapy ◽  
Renal Cell ◽  
First Line ◽  
Line Setting

scholarly journals Effect of third- and fourth-line systemic therapies for metastatic renal cell carcinoma

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Sei Naito ◽  
Osamu Ichiyanagi ◽  
Tomoyuki Kato ◽  
Hidenori Kanno ◽  
Takafumi Narisawa ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Metastatic Renal Cell Carcinoma ◽  
Systemic Therapy ◽  
Renal Cell ◽  
Objective Response ◽  
Progression Free Survival ◽  
University Hospital ◽  
Line Therapy ◽  
Third Line

Abstract Data on the outcomes of third- or fourth-line therapy for metastatic renal cell carcinoma (mRCC) are limited. The aim of our study was to evaluate the efficacy of therapy beyond the second line. We retrospectively analysed data of mRCC patients who underwent systemic therapy at Yamagata University Hospital. The best objective response (BOR), response rate (RR), and progression-free survival (PFS) were assessed for each line of treatment. To investigate the correlation between overall survival (OS) and the number of treatment lines during a patient’s lifetime, the median OS was assessed using univariate and multivariate analyses. In the first-, second-, and third-line therapies, approximately 20% of patients had long PFS of >15 months. In targeted treatments beyond the third line, only one treatment suppressed disease progression for >10 months. Among patients who died during the follow-up period, those treated with triple and quadruple lines had similar OS (42.5 months vs. 48.4 months, respectively). Multivariate analysis showed that patients with triple or more lines of therapy had better OS; however, quadruple or more lines of therapy was not an independent prognostic factor. We concluded that third-line systemic therapy could improve OS; however, fourth-line therapy could not.

scholarly journals Prognostic impact of systemic therapy change in metastatic renal cell carcinoma treated with cytoreductive nephrectomy

2020 ◽  
Author(s):  
Hiroki Ishihara ◽  
Toshio Takagi ◽  
Tsunenori Kondo ◽  
Hironori Fukuda ◽  
Hidekazu Tachibana ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Metastatic Renal Cell Carcinoma ◽  
Systemic Therapy ◽  
Renal Cell ◽  
Immune Checkpoint Inhibitor ◽  
Prognostic Impact ◽  
Limited Data ◽  
Cytoreductive Nephrectomy ◽  
Histopathological Type

Abstract Objective Limited data are available regarding the effect of systemic therapy change in the post-cytokine era on survival of metastatic renal cell carcinoma (mRCC) patients undergoing cytoreductive nephrectomy (CN). Methods Overall, 161 patients with synchronously mRCC were retrospectively evaluated. The patients were classified into three groups based on the time of diagnosis: (i) early molecular-targeted therapy (mTT) (2008–2011), (ii) late mTT (2012–8/2016) and (iii) immune checkpoint inhibitor (ICI) eras (9/2016–2018). Overall survival (OS) after the diagnosis was compared among the eras. Results Of the 161 patients, 52 (32%), 75 (46%), and 34 patients (21%) were classified into the early mTT, late mTT and ICI eras, respectively. OS was significantly longer in the ICI and late mTT eras than that in the early mTT era (P = 0.0065 and P = 0.0010, respectively) but did not significantly differ between the ICI and late mTT eras (P = 0.389). In 112 patients undergoing CN and systemic therapy, OS was significantly longer in the ICI and late mTT eras than that in the early mTT era (P = 0.0432 and P = 0.0498, respectively) but did not significantly differ between the ICI and late mTT eras (P = 0.320). Multivariate analysis of OS in the 161 synchronous mRCC patients revealed that the era was an independent factor (P &lt; 0.0001), together with the histopathological type (P = 0.0130), CN status (P = 0.0010), International Metastatic Renal Cell Carcinoma Database Consortium risk (P = 0.0002) and liver metastasis status (P = 0.0124). Conclusion This retrospective analysis showed that systemic therapy change in the post-cytokine era improved OS of mRCC patients undergoing CN.

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