Sarcopenia and elevated inflammation are associated with poor survival outcomes after cytoreductive nephrectomy in patients with metastatic renal cell carcinoma (mRCC), according to research published in Cancer.

The study revealed that patients with mRCC who had sarcopenia and an elevated neutrophil-to-lymphocyte ratio (NLR ≥3.5) had the worst overall survival (OS) after cytoreductive nephrectomy.

For this study, researchers retrospectively analyzed data from 158 patients with mRCC who underwent cytoreductive nephrectomy between January 1, 2001, and December 31, 2014. The patients’ median age was 61.9 (range, 24.4 to 85.8) years, most (n=120) were men, and 48% were classified as having sarcopenia.

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The presence of sarcopenia was correlated with elevated NLR (P =.02), increased age at surgery (P =.001), lower BMI (P =.009), higher Motzer score (P =.019), and lower skeletal muscle density (P =.006).

At a median follow-up of 15.8 months, 99 patients had died. The median OS was significantly shorter in patients with sarcopenia (15.0 months) than in those without sarcopenia (29.4 months; P =.04). Among all the patients, those with an NLR of 3.5 or higher and sarcopenia had the worst median OS (10.2 months).

On multivariate analysis using the International Metastatic Renal Cell Carcinoma Database Consortium risk score, an NLR of 3.5 or higher with sarcopenia (hazard ratio [HR], 2.39; P =.007), a C-reactive protein (CRP) level of 10 mg/L or higher without sarcopenia (HR, 2.42; P =.016), and a CRP level of 10 mg/L or higher with sarcopenia (HR, 2.47; P =.007) were all significant predictors of OS.

“Sarcopenia and measures of high systemic inflammation are additively associated with inferior OS after [cytoreductive nephrectomy] and may be of use in preoperative risk stratification,” the researchers concluded. “Sarcopenia is an objective measure of nutrition that can assist in therapeutic counseling and decision-making for individualized treatment in mRCC.”

Disclosures: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.


Khan AI, Psutka SP, Patil DH, et al. Sarcopenia and systemic inflammation are associated with decreased survival after cytoreductive nephrectomy for metastatic renal cell carcinoma. Cancer. Published March 14, 2022. doi:10.1002/cncr.34174