The prognostic role of perirenal fat tissue in non-metastatic renal cell carcinoma.

ABSTRACT

PURPOSE: The aim of this study was to evaluate the impact of perirenal fat volume and perirenal fat density on prognosis in surgically treated non-metastatic renal cell carcinomas (RCC). METHODS AND MATERIALS All consecutive patients who underwent partial or total nephrectomy surgery between March 2019 and December 2021 were assessed. Measurements of perirenal fat volume and perirenal fat density were performed on computed tomography (CT) images. The relationship between progression and perirenal fat parameters was evaluated using ROC analysis, Cox regression analysis, and Kaplan-Meier analysis. RESULTS: In the study population comprising 118 patients diagnosed with RCC (74.6% male, mean age of 59.1 ± 11.8 years), the median follow-up duration was 43 months (interquartile range 33-51 months). Perirenal fat volume (AUC 0.669, 95% CI 0.538-0.799, p = 0.011) and perirenal fat density (AUC 0.680, 95% CI 0.558-0.803, p = 0.007) demonstrated acceptable discrimination performance in predicting progression. There was a significant association between high perirenal fat volume and high perirenal fat density with poor progression-free survival (HR 1.007, 95% CI 1.003-1.011, p = 0.001 vs. HR 1.084, 95% CI 1.033-1.137, p = 0.001; respectively). CONCLUSION: High perirenal fat volume and high perirenal fat density are independent predictors for poor progression-free survival. Perirenal fat parameters, easily obtainable from preoperative CT images, may serve as potential tools in predicting the prognosis of non-metastatic RCC.