Mp10-16 Linear Muscle Segmentation for Metastatic Renal Cell Carcinoma: Changes in Clinic-Friendly Estimation Predict Survival in Patients Following Cytoreductive Nephrectomy

You have accessJournal of UrologyKidney Cancer: Advanced (including Drug Therapy) I (MP10)1 May 2024MP10-16 LINEAR MUSCLE SEGMENTATION FOR METASTATIC RENAL CELL CARCINOMA: CHANGES IN CLINIC-FRIENDLY ESTIMATION PREDICT SURVIVAL IN PATIENTS FOLLOWING CYTOREDUCTIVE NEPHRECTOMY Edouard H.* Nicaise, Benjamin N. Schmeusser, Adil Ali, Eric Midenberg, Arnold R. Palacios, Ethan Kearns, Sriram Ambadi, Sarah P. Psutka, Bassel Nazha, Jacqueline T. Brown, Kenneth Ogan, Mehmet A. Bilen, and Viraj A. Master Edouard H.* NicaiseEdouard H.* Nicaise , Benjamin N. SchmeusserBenjamin N. Schmeusser , Adil AliAdil Ali , Eric MidenbergEric Midenberg , Arnold R. PalaciosArnold R. Palacios , Ethan KearnsEthan Kearns , Sriram AmbadiSriram Ambadi , Sarah P. PsutkaSarah P. Psutka , Bassel NazhaBassel Nazha , Jacqueline T. BrownJacqueline T. Brown , Kenneth OganKenneth Ogan , Mehmet A. BilenMehmet A. Bilen , and Viraj A. MasterViraj A. Master View All Author Informationhttps://doi.org/10.1097/01.JU.0001008588.39303.c9.16AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Baseline sarcopenia and postoperative changes in muscle mass are independently associated with overall survival (OS) in patients with metastatic renal cell carcinoma (mRCC) undergoing cytoreductive nephrectomy (CN). Here we examine the relationship between preoperative (baseline) and postoperative changes in muscle quantity with survival outcomes following CN as determined by linear segmentation, a fast and clinic-friendly tool. METHODS: Our nephrectomy database was reviewed for patients with metastatic disease who underwent CN for clear cell, papillary, or chromophobe RCC. Linear segmentation of the bilateral psoas/paraspinal muscles was completed for baseline imaging within 60 days of surgery and imaging up to 1 year postoperatively. ANOVA for numerical and chi-square for categorical variables were used to test for differences between groups according to percent change in linear muscle index (LMI, cm2/m2). Multivariable models estimated COX hazard ratios for cancer-specific survival (CSS) and OS according to LMI percent change. Kaplan Meier curves estimated CSS and OS. RESULTS: From 2004-2020, 190 patients were included: 48 stable (25.3%; LMI change <5% 0Δ), 54 increase (28.4%; LMI+5% +Δ), and 88 decrease (46.3%; LMI -5% -Δ). Median time from baseline imaging to surgery was 18 days, while time from surgery to postoperative imaging was 119 days. Patients with +Δ had lower baseline LMI than -Δ or 0Δ (28.5 vs. 32.4 vs. 32.5 cm2/m2; p=0.003). 0Δ LMI had lower rates of pN1 disease than other groups (27.1% 0Δ vs. 42.6% +Δ vs. 45.5% -Δ; p=0.019). No other differences in pathology were noted. Median CSS and OS were highest among patients with 0Δ LMI (CSS: not reached 0Δ vs. 61.9 +Δ vs. 37.4 -Δ months; p=0.0018 || OS: 67.2 0Δ vs. 48.5 +Δ vs. 26.4 -Δ months; p=0.0007). Median follow-up was 56 months for survivors. Factors associated with cancer-specific mortality and all-cause mortality are listed in Table 1. CONCLUSIONS: Change in muscle mass after CN, as measured by the linear muscle segmentation technique, is independently associated with OS and CSS in patients following CN. Of note, lack of change demonstrated greatest survival, potentially secondary to high baseline muscle mass. Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e146 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Edouard H.* Nicaise More articles by this author Benjamin N. Schmeusser More articles by this author Adil Ali More articles by this author Eric Midenberg More articles by this author Arnold R. Palacios More articles by this author Ethan Kearns More articles by this author Sriram Ambadi More articles by this author Sarah P. Psutka More articles by this author Bassel Nazha More articles by this author Jacqueline T. Brown More articles by this author Kenneth Ogan More articles by this author Mehmet A. Bilen More articles by this author Viraj A. Master More articles by this author Expand All Advertisement PDF downloadLoading ...