Prognostic value of preoperative radiographic perinephric fat features in renal cell carcinoma patients undergoing surgery

Yuh-Ren Kuo; Ya-Che Lee; Chung-Teng Wang; Wan-Chen Liu; Chien-Hui Ou; Kun-Che Lin; Tsung-Han Cheng; Hau-Chern Jan; Che-Yuan Hu

Asian Journal of Surgery (May 2024)

Prognostic value of preoperative radiographic perinephric fat features in renal cell carcinoma patients undergoing surgery

Yuh-Ren Kuo,
Ya-Che Lee,
Chung-Teng Wang,
Wan-Chen Liu,
Chien-Hui Ou,
Kun-Che Lin,
Tsung-Han Cheng,
Hau-Chern Jan,
Che-Yuan Hu

Affiliations

Yuh-Ren Kuo: Department of Urology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, 704, Taiwan, ROC
Ya-Che Lee: Department of Urology, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi, 600, Taiwan, ROC
Chung-Teng Wang: Department of Microbiology and Immunology, College of Medicine, National Cheng Kung University, Tainan, 704, Taiwan, ROC
Wan-Chen Liu: Department of Medical Imaging, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, 704, Taiwan, ROC
Chien-Hui Ou: Department of Urology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, 704, Taiwan, ROC; Department of Urology, College of Medicine, National Cheng Kung University, Tainan, 704, Taiwan, ROC
Kun-Che Lin: Department of Urology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, 704, Taiwan, ROC
Tsung-Han Cheng: Department of Urology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, 704, Taiwan, ROC
Hau-Chern Jan: Department of Urology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, 704, Taiwan, ROC; Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, 704, Taiwan, ROC; Corresponding author. Department of Urology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, No.138, Shengli Road, Tainan, 704, Taiwan, ROC.
Che-Yuan Hu: Department of Urology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, 704, Taiwan, ROC; Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, 704, Taiwan, ROC; Corresponding author. Department of Urology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, No.138, Shengli Road, Tainan, 704, Taiwan, ROC.

Journal volume & issue: Vol. 47, no. 5
pp. 2188 – 2194

Abstract

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Background: We aimed to assess the prognostic importance of perinephric fat features in images of patients with non-metastatic renal cell carcinoma (RCC) undergoing surgery. Methods: We enrolled RCC patients who underwent surgical treatment between 2011 and 2019. Two characteristics, including perinephric fat thickness and perinephric fat stranding, were evaluated using preoperative computed tomography or magnetic resonance images. The association between perinephric fat characteristics and disease progression was examined by Kaplan-Meier survival analysis and Cox regression model. Results: In a multivariate Cox proportional hazards model adjusting for tumor stage, intratumoral necrosis, and neutrophil-to-lymphocyte ratio, we found that patients in the thin perinephric fat group (<1 cm) had a poorer progression-free survival (PFS) compared to the thick perinephric fat group (≥1 cm) (HR 2.8; 95% CI 1.175–6.674, p = 0.02). Additionally, the fat stranding group had a poorer PFS than the non-stranding group (HR 3.852; 95% CI 1.082–13.704, p = 0.037). The non-stranding with thick perinephric fat group exhibits the highest cumulative PFS while the stranding with thin perinephric fat group has the lowest cumulative PFS. In receiver operating characteristic curve analysis, combing these two perinephric fat characteristics with tumor stage can achieve a better discriminatory power than tumor stage alone. Conclusions: Our study indicates that the evaluation of image-based perinephric fat features is a simple, straightforward, reproducible tool for predicting RCC prognosis and may assist in preoperative risk stratification.

Published in Asian Journal of Surgery

ISSN: 1015-9584 (Print)
Publisher: Elsevier
Country of publisher: Hong Kong
LCC subjects: Medicine: Surgery
Website: http://www.journals.elsevier.com/asian-journal-of-surgery/

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