Subcutaneous Adipose Tissue Reduction in Patients with Clear Cell Renal Cell Carcinoma and Peritumoral Collateral Vessels: A Retrospective Observational Study

Background: peritumoral collateral vessels adjacent to renal cell carcinoma (RCC) can be encountered in clinical practice. Cancer cachexia is defined as a decrease of adipose and skeletal muscle tissues. In this study we evaluated, using a quantitative CT imaging-based approach, the distribution of abdominal adipose tissue in clear cell RCC (ccRCC) male patients with and without collateral vessels. Methods: between November 2019 and February 2020, in this retrospective study we enrolled 106 ccRCC male Caucasian patients divided into two groups: a ccRCCa group without collateral vessels (n = 48) and a ccRCCp group with collateral vessels (n = 58). The total adipose tissue (TAT), visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) areas were measured in both groups. Moreover, the VAT/SAT ratio was calculated for each subject. Results: a statistically significant difference between the two groups was found in the SAT area (p < 0.05), while no significant differences were found in the TAT area, VAT area and VAT/SAT ratio. Conclusion: this study demonstrates a reduction of SAT in ccRCC patients with peritumoral collateral vessels.

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Increased visceral adipose tissue in male patients with clear cell renal cell carcinoma

Clinical Cancer Investigation Journal ◽

10.4103/ccij.ccij_62_18 ◽

2018 ◽

Vol 7 (4) ◽

pp. 132 ◽

Cited By ~ 4

Author(s):

Federico Greco ◽

Vincenzo Cirimele ◽

CarloAugusto Mallio ◽

BrunoBeomonte Zobel ◽

RosarioFrancesco Grasso

Keyword(s):

Renal Cell Carcinoma ◽

Adipose Tissue ◽

Cell Carcinoma ◽

Visceral Adipose Tissue ◽

Renal Cell ◽

Clear Cell ◽

Cell Renal Cell Carcinoma ◽

Male Patients ◽

Visceral Adipose

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Increased visceral adipose tissue in male patients with non-clear cell renal cell carcinoma

La radiologia medica ◽

10.1007/s11547-020-01146-6 ◽

2020 ◽

Vol 125 (6) ◽

pp. 538-543 ◽

Cited By ~ 4

Author(s):

Federico Greco ◽

Carlo Augusto Mallio ◽

Raffaele Grippo ◽

Laura Messina ◽

Silvia Vallese ◽

...

Keyword(s):

Renal Cell Carcinoma ◽

Adipose Tissue ◽

Cell Carcinoma ◽

Visceral Adipose Tissue ◽

Renal Cell ◽

Clear Cell ◽

Cell Renal Cell Carcinoma ◽

Male Patients ◽

Visceral Adipose

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Genomic Analysis Reveals Novel Specific Metastatic Mutations in Chinese Clear Cell Renal Cell Carcinoma

BioMed Research International ◽

10.1155/2020/2495157 ◽

2020 ◽

Vol 2020 ◽

pp. 1-9

Author(s):

Hui Meng ◽

Xuewen Jiang ◽

Jianfeng Cui ◽

Gang Yin ◽

Benkang Shi ◽

...

Keyword(s):

Renal Cell Carcinoma ◽

Cell Carcinoma ◽

Renal Cell ◽

Clear Cell ◽

Genomic Analysis ◽

Renal Clear Cell Carcinoma ◽

Genomic Feature ◽

Cell Renal Cell Carcinoma ◽

Hybridization Capture ◽

Significant Difference

Clear cell renal cell carcinoma (ccRCC) accounts for more than 75% of renal cell carcinoma. Nearly 25% of ccRCC patients were diagnosed with metastasis. Though the genomic profile of ccRCC has been widely studied, the difference between localized and metastatic ccRCC was not clarified. Primary tumor samples and matched whole blood were collected from 106 sporadic patients diagnosed with renal clear cell carcinoma at Qilu Hospital of Shandong University from January 2017 to November 2019, and 17 of them were diagnosed with metastasis. A hybridization capture-based next-generation sequencing of 618 cancer-related genes was performed to investigate the somatic and germline variants, tumor mutation burden (TMB), and microsatellite instability (MSI). Five genes with significantly different prevalence were identified in the metastatic group, especially TOP1 (17.65% vs. 0%) and SNCAIP (17.65% vs. 0%). The altered frequency of PBRM1 (0% vs. 27%) and BAP1 (24% vs. 10%) differed between the metastatic and nonmetastatic groups, which may relate to the prognosis. Of these 106 patients, 42 patients (39.62%) had at least one alteration in DNA damage repair (DDR) genes, including 58.82% of metastatic ccRCC patients and 35.96% of ccRCC patients without metastasis. Ten pathogenic or likely pathogenic (P/LP) variants were identified in 11 sporadic clear cell renal cell carcinoma patients (10.38%), including rarely reported ATM (n=1), MUTYH (n=1), NBN (n=1), RAD51D (n=1), and BRCA2 (n=1). No significant difference in the ratio of P/LP variant carriers or TMB was identified between the metastatic and nonmetastatic groups. We found a unique genomic feature of Chinese metastatic ccRCC patients with a higher prevalence of alterations in DDR, TOP1, and SNCAIP. Further investigated studies and drug development are needed in the future.

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Visceral Adiposity as a Significant Predictor of Sunitinib-Induced Dose-Limiting Toxicities and Survival in Patients with Metastatic Clear Cell Renal Cell Carcinoma

Cancers ◽

10.3390/cancers12123602 ◽

2020 ◽

Vol 12 (12) ◽

pp. 3602

Author(s):

Jee Soo Park ◽

Kyo Chul Koo ◽

Doo Yong Chung ◽

Sun Il Kim ◽

Jeongho Kim ◽

...

Keyword(s):

Renal Cell Carcinoma ◽

Body Composition ◽

Adipose Tissue ◽

Cell Carcinoma ◽

Renal Cell ◽

Clear Cell ◽

Univariate Analysis ◽

Progression Free Survival ◽

Visceral Adiposity ◽

Cell Renal Cell Carcinoma

Sunitinib is a first-line treatment for metastatic renal cell carcinoma (mRCC). Little is known about the predictive factors of sunitinib-induced dose-limiting toxicity (DLT) in Asian populations. We investigated whether body composition predicts sunitinib-induced DLT. We retrospectively reviewed sunitinib-treated Korean patients with clear cell mRCC from eight institutions. Body composition was measured using computed tomography. DLT was defined as any adverse event leading to dose reduction or treatment discontinuation. Univariate analysis was used to compare body composition indices, and logistic regression analyses were performed for factors predicting early DLT. Overall, 111/311 (32.5%) of patients experienced DLT. Significant differences were observed in the subcutaneous adipose tissue index (SATI; p = 0.001) and visceral adipose tissue index (VATI; p < 0.001) between patients with and without DLT. Multivariate analyses revealed that VATI (odds ratio: 1.013; p = 0.029) was significantly associated with early DLT. Additionally, 20% of patients who had a body mass index (BMI) greater than 23 kg/m2 and a low VATI experienced DLT, whereas 34.3% of the remaining groups had DLT (p = 0.034). Significant differences were observed for median progression-free survival (13.0 vs. 26.0 months, respectively; p = 0.006) between patients with low and high VATI. Visceral adiposity was a significant predictor of sunitinib-associated DLT and survival. Patients with a low VATI and a BMI greater than 23 kg/m2 experienced lower DLTs.

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Composition of Perinephric Fat and Fuhrman Grade in Clear Cell Renal Cell Carcinoma: The Role of Peritumoral Collateral Vessels

Applied Sciences ◽

10.3390/app11093941 ◽

2021 ◽

Vol 11 (9) ◽

pp. 3941

Author(s):

Federico Greco ◽

Luigi Giuseppe Quarta ◽

Caterina Bernetti ◽

Rosario Francesco Grasso ◽

Mark Ivo van Berge Henegouwen ◽

...

Keyword(s):

Renal Cell Carcinoma ◽

Cell Carcinoma ◽

Renal Cell ◽

Clear Cell ◽

Cell Renal Cell Carcinoma ◽

Fuhrman Grade ◽

Potential Association ◽

Novel Association ◽

Male Patients ◽

Collateral Vessels

Background: The aim of this study was to investigate whether the presence of peritumoral collateral vessels could be indicative of a high Fuhrman grade (e.g., III and IV) in clear cell renal cell carcinoma (ccRCC). Methods: Between November 2019 and February 2020, a total of 267 ccRCC patients with histology-proven diagnoses were retrospectively analyzed and screened. Imaging analysis was performed on computed tomography (CT) images to assess the presence of peritumoral collateral vessels and understand the potential association with high Fuhrman grades. These vessels are defined as dilated and macroscopically visible peritumoral renal capsular veins. Results: A total of 190 ccRCC patients were included in the study, considering the exclusion criteria. In patients with peritumoral collateral vessels, there was a statistically significant greater presence of ccRCC with a high Fuhrman grade both among the total cohort of patients regardless gender (n = 190) (p < 0.001) as well as among ccRCC male patients only (n = 127) (p < 0.005). Conclusion: Here, we show a novel association between peritumoral collateral vessels and ccRCC with high Fuhrman grades in male patients. The presence of peritumoral collateral vessels in perinephric adipose tissue can be indicative of more aggressive ccRCC.

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The Potential of Visceral Adipose Tissue in Distinguishing Clear Cell Renal Cell Carcinoma from Renal Angiomyolipoma with Minimal Fat

Cancer Management and Research ◽

10.2147/cmar.s336920 ◽

2021 ◽

Vol Volume 13 ◽

pp. 8907-8914

Author(s):

Jianhu Liu ◽

Jie Bao ◽

Weijie Zhang ◽

Qiaoxing Li ◽

Jianquan Hou ◽

...

Keyword(s):

Renal Cell Carcinoma ◽

Adipose Tissue ◽

Cell Carcinoma ◽

Visceral Adipose Tissue ◽

Renal Cell ◽

Clear Cell ◽

Renal Angiomyolipoma ◽

Cell Renal Cell Carcinoma ◽

Visceral Adipose ◽

Minimal Fat

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Increased visceral adipose tissue in clear cell renal cell carcinoma with and without peritumoral collateral vessels

British Journal of Radiology ◽

10.1259/bjr.20200334 ◽

2020 ◽

Vol 93 (1112) ◽

pp. 20200334

Author(s):

Federico Greco ◽

Luigi Giuseppe Quarta ◽

Rosario Francesco Grasso ◽

Bruno Beomonte Zobel ◽

Carlo Augusto Mallio

Keyword(s):

Renal Cell Carcinoma ◽

Adipose Tissue ◽

Visceral Adipose Tissue ◽

Renal Cell ◽

Clear Cell ◽

Control Group ◽

Cell Renal Cell Carcinoma ◽

Collateral Vessels ◽

Visceral Adipose ◽

And Control

Objective: The excessive amount of adipose tissue, mainly visceral, determines adiposopathy. With respect to oncogenesis, visceral adipose tissue (VAT) releases secretes adipokines, proinflammatory citokines and growth factors, considered mediating molecules in the development of obesity-related tumors. In this study, we quantify VAT in male patients with clear cell renal cell carcinoma (ccRCC) subgrouped according to the presence or absence of peritumoral collateral vessels. Methods: in this retrospective study, we enrolled 141 male caucasian patients divided into 2 groups: the ccRCC group (n = 106) composed of patients with ccRCC and control group (n = 35). The ccRCC group was further divided into two subgroups: the ccRCCa subgroup which showed absence of collateral vessels (n = 48) and ccRCCp subgroup with collateral vessels (n = 58). Total adipose tissue (TAT) area, VAT area and subcutaneous adipose tissue (SAT) area were measured in the groups and subgroups. VAT/SAT ratio was calculated for each subject. Results: Statistically significant differences were obtained between ccRCC group and control group for TAT area (p < 0.005), VAT area (p < 0.005) and SAT area (p = 0.01). Between ccRCCa subgroup and control group for TAT area (p < 0.001), VAT area (p = 0.005) and SAT area (p = 0.001). Between ccRCCp subgroup and control group for TAT area (p = 0.01) and VAT area (p = 0.01). Conclusion: This study confirms the increase of abdominal, especially visceral, adipose tissue in ccRCC patients and demonstrates a significant VAT accumulation in both categories of patients with and without peritumoral collateral vessels. Advances in knowledge: Visceral adiposity is present in patients with ccRCC regardless the presence of peritumoral collateral vessels, with surprisingly stronger results in the ccRCCa subgroup.

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A CT-Based Radiomics Approach for the Differential Diagnosis of Sarcomatoid and Clear Cell Renal Cell Carcinoma

BioMed Research International ◽

10.1155/2020/7103647 ◽

2020 ◽

Vol 2020 ◽

pp. 1-10

Author(s):

Xiaoli Meng ◽

Jun Shu ◽

Yuwei Xia ◽

Ruwu Yang

Keyword(s):

Renal Cell Carcinoma ◽

Cell Carcinoma ◽

Renal Cell ◽

Clear Cell ◽

Characteristic Curve ◽

Univariate Analysis ◽

Image Features ◽

Regression Method ◽

Cell Renal Cell Carcinoma ◽

Significant Difference

This study was aimed at building a computed tomography- (CT-) based radiomics approach for the differentiation of sarcomatoid renal cell carcinoma (SRCC) and clear cell renal cell carcinoma (CCRCC). It involved 29 SRCC and 99 CCRCC patient cases, and to each case, 1029 features were collected from each of the corticomedullary phase (CMP) and nephrographic phase (NP) image. Then, features were selected by using the least absolute shrinkage and selection operator regression method and the selected features of the two phases were explored to build three radiomics approaches for SRCC and CCRCC classification. Meanwhile, subjective CT findings were filtered by univariate analysis to construct a radiomics model and further selected by Akaike information criterion for integrating with the selected image features to build the fifth model. Finally, the radiomics models utilized the multivariate logistic regression method for classification and the performance was assessed with receiver operating characteristic curve (ROC) and DeLong test. The radiomics models based on the CMP, the NP, the CMP and NP, the subjective findings, and the combined features achieved the AUC (area under the curve) value of 0.772, 0.938, 0.966, 0.792, and 0.974, respectively. Significant difference was found in AUC values between each of the CMP radiomics model (0.0001≤p≤0.0051) and the subjective findings model (0.0006≤p≤0.0079) and each of the NP radiomics model, the CMP and NP radiomics model, and the combined model. Sarcomatoid change is a common pathway of dedifferentiation likely occurring in all subtypes of renal cell carcinoma, and the CT-based radiomics approaches in this study show the potential for SRCC from CCRCC differentiation.

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