Prognostic Value of Sarcopenia and Albumin in the Surgical Management of Localized Renal Cell Carcinoma

•A critical deficiency in skeletal muscle mass, defined as sarcopenia, has been associated with increased postoperative morbidity and mortality in patients with kidney cancer.•We investigated the prognostic value of preoperative sarcopenia and nutritional status, as determined by serum albumin, amon...

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Published in:Urologic oncology 2023-01, Vol.41 (1), p.50.e19-50.e26
Main Authors: Midenberg, Eric, Higgins, Michelle I., Schmeusser, Benjamin N., Patil, Dattatraya H., Zaldumbide, Joel, Martini, Dylan J., Steele, Sean, Williams, Milton, Nabavizadeh, Reza, Psutka, Sarah P., Ogan, Kenneth, Bilen, Mehmet Asim, Master, Viraj A.
Format: Article
Language:English
Subjects:
Albumin
Body composition
Nephrectomy
Nutrition
Renal cell carcinoma
Sarcopenia
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Summary:•A critical deficiency in skeletal muscle mass, defined as sarcopenia, has been associated with increased postoperative morbidity and mortality in patients with kidney cancer.•We investigated the prognostic value of preoperative sarcopenia and nutritional status, as determined by serum albumin, among patients with localized RCC undergoing extirpative surgery.•Sarcopenia was significantly associated with poor OS, while hypoalbuminemia was an independent predictor of decreased OS, RFS, and CSS.•Stratification of sarcopenia and albumin status into composite risk groups revealed more robust associations with OS, RFS, and CSS with corresponding increases in risk. A universally accepted model for preoperative surgical risk stratification in localized RCC patients undergoing nephrectomy is currently lacking. Both the evaluation of body composition and nutritional status has demonstrated prognostic value for patients with cancer. This study aims to investigate the potential associations between sarcopenia and hypoalbuminemia and survival outcomes in patients with localized kidney cancer treated with partial or radical nephrectomy. We retrospectively analyzed 473 patients with localized RCC managed with radical and partial nephrectomy. Skeletal muscle index (SMI) was measured from preoperative CT and MRI. Sarcopenic criteria were created using BMI- and sex-stratified thresholds. Relationships between sarcopenia and hypoalbuminemia (Albumin
ISSN:1078-1439
1873-2496
DOI:10.1016/j.urolonc.2022.09.020