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Influence of nutritional deficiency on prognosis of renal cell carcinoma ( RCC )
Author(s) -
Ko Kyungtae,
Park Young H.,
Lee Jeong W.,
Ku Ja H.,
Kwak Cheol,
Kim Hyeon H.
Publication year - 2013
Publication title -
bju international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 1464-4096
DOI - 10.1111/bju.12275
Subject(s) - medicine , renal cell carcinoma , hazard ratio , nephrectomy , gastroenterology , confidence interval , body mass index , metastasis , albumin , kidney , cancer
Objective To evaluate the prognosis of patients with renal cell carcinoma ( RCC ) by nutritional status defined by body mass index ( BMI ), serum albumin and cholesterol.Patients and Methods This study retrospectively enrolled 1437 patients who underwent radical nephrectomy (932) or partial nephrectomy (505) for RCC . We assigned nutritional status according to the presence of none or one nutritional risk factor (control group) and two or all three of the following nutritional risk factors (nutritional deficiency group). The nutritional factors and thresholds were preoperative albumin level (<3.5 g/dL), preoperative cholesterol level (<220 mg/dL), and preoperative BMI (<23 kg/m 2 )Results The patients' mean ( sd ) age was 55.23 (12.41) years and BMI was 24.36 (3.17) kg/m 2 . The mean ( sd ) serum cholesterol level was 180.07 (38.24) mg/dL, and the albumin level was 4.2 (0.45) g/dL. In all, 141 (9.8%) patients had none of the nutritional deficiency criteria, 802 (55.8%) had one, 429 (29.9%) had two, and 65 (4.5%) had all three. Clinicopathological variables, i.e. female gender, high tumour stage, positive lymph node metastasis, positive distant metastasis, high nuclear grade and non‐clear cell type histopathology were associated with the nutritional deficiency group. In multivariate C ox analysis, nutritional deficiency was an independent predictor for RCC recurrence (hazard ratio [ HR ] 1.39, 95% confidence interval [ CI ] 1.05–1.83, P = 0.020) and RCC ‐related mortality ( HR 2.06, 95% CI 1.39–3.03, P < 0.001).Conclusion Nutritional deficiency defined by BMI , serum albumin and cholesterol is an important factor that predicts postoperative prognosis of patients with RCC who have undergone radical or partial nephrectomy.