コバヤシ　ヒロヒト   Kobayashi Hirohito   小林　博人    所属   医学部 医学科（附属足立医療センター）    職種   准教授
論文種別	原著
言語種別	英語
査読の有無	査読あり
表題	Impact of sarcopenia on post-operative outcomes following nephrectomy and tumor thrombectomy for renal cell carcinoma with inferior vena cava thrombus.
掲載誌名	正式名：Japanese journal of clinical oncology 略　 称：Jpn J Clin Oncol ISSNコード：03682811/14653621
掲載区分	国外
巻・号・頁	51(5),pp.819-825
著者・共著者	WATANABE Shun†, ISHIHARA Hiroki*, TAKAGI Toshio, KONDO Tsunenori, ISHIYAMA Ryo, FUKUDA Hironori, YOSHIDA Kazuhiko, IIZUKA Junpei, KOBAYASHI Hirohito, ISHIDA Hideki, TANABE Kazunari
発行年月	2021/04
概要	OBJECTIVE:Sarcopenia is associated with oncological outcomes in various types of cancer. However, the impact of sarcopenia in renal cell carcinoma with inferior vena cava thrombus remains unclear. We herein evaluated the prognostic significance of sarcopenia for renal cell carcinoma with inferior vena cava thrombus following nephrectomy and thrombectomy.METHODS:Patients who underwent nephrectomy and thrombectomy for renal cell carcinoma with inferior vena cava thrombus at our department between 2004 and 2019 were retrospectively evaluated. Their sarcopenic status, determined by sex, body mass index and skeletal muscle index, was calculated using pre-surgical radiographic imaging. We compared the post-operative cancer-specific survival and overall survival, surgical data and duration of post-operative hospitalization of sarcopenic and non-sarcopenic patients.RESULTS:Out of 83 patients, 54 (65%) were sarcopenic. Sarcopenic patients had significantly shorter cancer-specific survival (median: 33.3 months vs. not reached, P = 0.0323) and overall survival (32.0 months vs. not reached, P = 0.0173) than non-sarcopenic patients. Furthermore, multivariate analyses showed that sarcopenia was an independent factor for cancer-specific survival (hazard ratio: 2.76, P = 0.0212) and overall survival (hazard ratio: 2.93, P = 0.014). The incidence rate of surgical complications (any grade: 35.2% vs. 27.6%, P = 0.482; grades ≥ 3: 7.4% vs. 10.3%, P = 0.648) or duration of post-operative hospitalization (median: 11 vs. 10 days, P = 0.148) was not significantly different between sarcopenic and non-sarcopenic patients.CONCLUSIONS:In conclusion, this study showed that sarcopenia was an independent prognostic factor for renal cell carcinoma with inferior vena cava thrombus after nephrectomy and tumor thrombectomy. Thus, sarcopenia evaluation can be utilized as an effective prognosticator of post-operative survival.
DOI	10.1093/jjco/hyaa275
PMID	33558883