Association between sarcopenia based on psoas muscle index and the response to nivolumab in metastatic renal cell carcinoma: A retrospective study
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...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Korean Urological Association
2022-07-01
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| Series: | Investigative and Clinical Urology |
| Subjects: | |
| Online Access: | https://www.icurology.org/pdf/10.4111/icu.20220028 |
| _version_ | 1828517108980383744 |
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| author | Hideto Ueki Takuto Hara Yasuyoshi Okamura Yukari Bando Tomoaki Terakawa Junya Furukawa Kenichi Harada Yuzo Nakano Masato Fujisawa |
| author_facet | Hideto Ueki Takuto Hara Yasuyoshi Okamura Yukari Bando Tomoaki Terakawa Junya Furukawa Kenichi Harada Yuzo Nakano Masato Fujisawa |
| author_sort | Hideto Ueki |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-12-11T18:37:10Z |
| format | Article |
| id | doaj.art-51d31060bc354668aae9fb3622286015 |
| institution | Directory Open Access Journal |
| issn | 2466-0493 2466-054X |
| language | English |
| last_indexed | 2024-12-11T18:37:10Z |
| publishDate | 2022-07-01 |
| publisher | Korean Urological Association |
| record_format | Article |
| series | Investigative and Clinical Urology |
| spelling | doaj.art-51d31060bc354668aae9fb36222860152022-12-22T00:54:44ZengKorean Urological AssociationInvestigative and Clinical Urology2466-04932466-054X2022-07-0163441542410.4111/icu.20220028Association between sarcopenia based on psoas muscle index and the response to nivolumab in metastatic renal cell carcinoma: A retrospective studyHideto Ueki 0https://orcid.org/0000-0002-7742-4528Takuto Hara1https://orcid.org/0000-0003-4524-2815Yasuyoshi Okamura 2https://orcid.org/0000-0002-8466-3949Yukari Bando3https://orcid.org/0000-0001-7736-1216Tomoaki Terakawa4https://orcid.org/0000-0002-4447-6516Junya Furukawa 5https://orcid.org/0000-0001-8974-9218Kenichi Harada6https://orcid.org/0000-0002-0242-9674Yuzo Nakano7https://orcid.org/0000-0002-0029-0023Masato Fujisawa8Department of Urology, Kobe University Graduate School of Medicine, Kobe, Japan.Department of Urology, Kobe University Graduate School of Medicine, Kobe, Japan.Department of Urology, Kobe University Graduate School of Medicine, Kobe, Japan.Department of Urology, Kobe University Graduate School of Medicine, Kobe, Japan.Department of Urology, Kobe University Graduate School of Medicine, Kobe, Japan.Department of Urology, Kobe University Graduate School of Medicine, Kobe, Japan.Department of Urology, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan.Department of Urology, Kobe University Graduate School of Medicine, Kobe, Japan.Department of Urology, Kobe University Graduate School of Medicine, Kobe, Japan.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.https://www.icurology.org/pdf/10.4111/icu.20220028psoas musclesrenal cell carcinomasarcopeniaskeletal musclesurvival rate |
| spellingShingle | Hideto Ueki Takuto Hara Yasuyoshi Okamura Yukari Bando Tomoaki Terakawa Junya Furukawa Kenichi Harada Yuzo Nakano Masato Fujisawa Association between sarcopenia based on psoas muscle index and the response to nivolumab in metastatic renal cell carcinoma: A retrospective study Investigative and Clinical Urology psoas muscles renal cell carcinoma sarcopenia skeletal muscle survival rate |
| title | Association between sarcopenia based on psoas muscle index and the response to nivolumab in metastatic renal cell carcinoma: A retrospective study |
| title_full | Association between sarcopenia based on psoas muscle index and the response to nivolumab in metastatic renal cell carcinoma: A retrospective study |
| title_fullStr | Association between sarcopenia based on psoas muscle index and the response to nivolumab in metastatic renal cell carcinoma: A retrospective study |
| title_full_unstemmed | Association between sarcopenia based on psoas muscle index and the response to nivolumab in metastatic renal cell carcinoma: A retrospective study |
| title_short | Association between sarcopenia based on psoas muscle index and the response to nivolumab in metastatic renal cell carcinoma: A retrospective study |
| title_sort | association between sarcopenia based on psoas muscle index and the response to nivolumab in metastatic renal cell carcinoma a retrospective study |
| topic | psoas muscles renal cell carcinoma sarcopenia skeletal muscle survival rate |
| url | https://www.icurology.org/pdf/10.4111/icu.20220028 |
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