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Submitted
Abstract
Perirenal Fat Thickness as a Significant Predictor of Prognosis and Postoperative Renal Function in Renal Cancer Surgery Patients: a retrospective cohort study
Non-Moderated Poster Abstract
Clinical Research
Oncology: Kidney (non-UTUC)
Author's Information
1
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China
Lihao Zhang zhanglh1@sysucc.org.cn Sun Yat -sen University Urology Guangzhou China *
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Abstract Content
Renal cell carcinoma (RCC) accounts for a significant number of kidney malignancy-related fatalities globally. Perirenal Fat Thickness (PRFT) may indicate a state of nutritional excess, which is potentially linked to both the incidence and prognosis of kidney cancer. However, the relationship between PRFT and overall survival (OS), as well as its predictive value for postoperative estimated glomerular filtration rate (eGFR), remains unclear. This study aims to investigate the association between PRFT and OS in RCC patients and evaluate its role as a predictor of postoperative renal function.
A retrospective cohort of 1647 RCC patients treated between 2014 and 2021 was analyzed. Patients were divided into two groups: Radical nephrectomy (RN) Partial nephrectomy (PN) Preoperative measurements included: Visceral fat area PRFT Subcutaneous fat area Statistical analyses performed: Kaplan-Meier curves compared OS between high and low PRFT groups. Cox regression analyses identified prognostic factors for OS. Linear regression analyses assessed predictors of postoperative eGFR.
In univariate analysis, PRFT significantly influenced OS in RN patients (HR: 0.32; 95% CI: 0.19-0.52; P < 0.001) but not in PN patients. After adjusting for covariates (age, sex, sarcomatoid features, necrosis, T stage, Fuhrman grade, smoking status, subcutaneous adipose tissue, and BMI), PRFT remained an independent risk factor for OS (HR: 0.56; 95% CI: 0.33-0.96; P < 0.001). Kaplan-Meier analysis showed that higher PRFT was associated with improved OS in RN patients. Univariate linear regression revealed that high PRFT correlated with reduced postoperative eGFR in both RN (β = -0.2, P = 0.002) and PN (β = -0.34, P < 0.001) groups; however, this correlation was not significant after multivariate adjustment.
Low PRFT is independently associated with higher mortality in RCC patients undergoing radical nephrectomy, suggesting that perirenal fat may have a protective effect. Conversely, high PRFT may predict reduced postoperative eGFR in patients undergoing both RN and PN, although this correlation requires further validation in future studies.
perirenal fat thickness, prognosis, renal function, renal cancer
 
Flowchart of study population in the study and measurement of PRFT, VAT and SAT.
 
The overall survival of patients undergoing RN and PN according to PRFT (A, B), VAT(C, D) and SAT(E, F), which were all measured before surgery.
 
The scatter plot with fitting linear regression model of patients with RCC undergoing RN and PN.
 
 
 
 
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