|
KMID : 1011820220630040415
|
|
Investigative and Clinical Urology
2022 Volume.63 No. 4 p.415 ~ p.424
|
|
|
Association between sarcopenia based on psoas muscle index and the response to nivolumab in metastatic renal cell carcinoma: A retrospective study
|
|
Ueki Hideto
Hara Takuto
Okamura Yasuyoshi
Bando Yukari
Terakawa Tomoaki
Furukawa Junya
Harada Kenichi
Nakano Yuzo
Fujisawa Masato
|
|
|
Abstract
|
|
|
Purpose: Two methods are used to identify sarcopenia by calculating skeletal muscle area on computed tomography: the skeletal muscle index (SMI) and the psoas muscle index (PMI). Programmed death (PD)-1 inhibitors are helpful in treating metastatic renal cell carcinoma (mRCC). However, there remains insufficient information regarding a clear and easy-to-use biomarker for predicting the response to PD-1 inhibitors in patients with mRCC. Therefore, we investigated the influence of sarcopenia on clinical outcomes in patients with mRCC undergoing treatment with nivolumab.
Materials and Methods: This study evaluated 96 patients with RCC who received nivolumab. The SMI and PMI were calculated for each patient and normalized for stature by use of the following formulas: SMI (cm2/m2)=([skeletal muscle cross-sectional area at the level of L3]/[height]2) and PMI (cm2/m2) = ([left-right sum of the psoas muscle areas at the level of L3]/[height]2). The relationship of the clinical variables with progression-free survival and overall survival (OS) was examined using a Cox proportional hazards model.
Results: According to the SMI-based definition of sarcopenia, 74.0% of patients had sarcopenia. However, according to the PMI-based definition of sarcopenia, only 34.3% of patients were diagnosed with sarcopenia. Multivariate analysis identified sarcopenia based on PMI (hazard ratio [HR], 3.85; 95% confidence interval [CI], 2.04?7.26; p<0.001) and International Metastatic RCC Database Consortium poor risk status (HR, 1.90; 95% CI, 1.03?3.50; p=0.041) as significant and independent prognostic factors of OS.
Conclusions: PMI-based sarcopenia is a significant prognostic factor for OS in patients with RCC who receive nivolumab therapy.
|
|
|
KEYWORD
|
|
|
Psoas muscles, Renal cell carcinoma, Sarcopenia, Skeletal muscle, Survival rate
|
|
|
FullTexts / Linksout information
|
|
|
|
|
|
Listed journal information
|
|
    
|