Decreased cross-sectional muscle area in male patients with clear cell renal cell carcinoma and peritumoral collateral vessels

doi:10.4329/wjr.v14.i4.82

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Apr 28, 2022 (publication date) through Mar 5, 2026

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World Journal of Radiology

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Retrospective Cohort Study

World J Radiol. Apr 28, 2022; 14(4): 82-90
Published online Apr 28, 2022. doi: 10.4329/wjr.v14.i4.82

Decreased cross-sectional muscle area in male patients with clear cell renal cell carcinoma and peritumoral collateral vessels

Federico Greco, Bruno Beomonte Zobel, Carlo Augusto Mallio

Federico Greco, Unità Operativa Complessa Diagnostica per Immagini Territoriale Aziendale, Cittadella della Salute Azienda Sanitaria Locale di Lecce, Lecce 73100, Italy

Bruno Beomonte Zobel, Carlo Augusto Mallio, Unit of Diagnostic Imaging, Università Campus Bio-Medico di Roma, Rome 00128, Italy

Author contributions: Greco F and Mallio CA contributed equally to this work; Greco F and Mallio CA designed the research; Greco F and Mallio CA performed the research; Greco F and Mallio CA analyzed the data; Greco F, Beomonte Zobel B, and Mallio CA validated the research; Greco F and Mallio CA wrote the paper; Greco F, Beomonte Zobel B, and Mallio CA supervised the research.

Institutional review board statement: All the procedures were retrospective and agreed with the Declaration of Helsinki. CT images and data of ccRCC patients were retrieved from The Cancer Imaging Archive (TCIA). The TCIA project received approval of the Institutional Review Board. This subsequent retrospective analysis was on the publicly available, anonymized data and did not require further review due to previous protections implemented by TCIA.

Conflict-of-interest statement: The authors declare that they have no conflict of interest to disclose.

Data sharing statement: The data presented in this study are openly available in The Cancer Imaging Archive (https://wiki.cancerimagingarchive.net/display/Public/TCGA-KIRC, accessed on 1 November 2019).

STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.

Corresponding author: Federico Greco, MD, Doctor, Unità Operativa Complessa Diagnostica per Immagini Territoriale Aziendale, Cittadella della Salute Azienda Sanitaria Locale di Lecce, Piazza Filippo Bottazzi, Lecce 73100, Italy. federicogreco@outlook.com

Received: October 24, 2021
Peer-review started: October 24, 2021
First decision: December 10, 2021
Revised: December 15, 2021
Accepted: March 25, 2022
Article in press: March 25, 2022
Published online: April 28, 2022
Processing time: 182 Days and 21.3 Hours

Abstract

BACKGROUND

Sarcopenia is the loss of skeletal muscle mass (SMM) and is a sign of cancer cachexia. Patients with advanced renal cell carcinoma (RCC) may show cachexia.

AIM

To evaluate the amount of SMM in male clear cell RCC (ccRCC) patients with and without collateral vessels.

METHODS

In this study, we included a total of 124 male Caucasian patients divided into two groups: ccRCCa group without collateral vessels (n = 54) and ccRCCp group with collateral vessels (n = 70). Total abdominal muscle area (TAMA) was measured in both groups using a computed tomography imaging-based approach. TAMA measures were also corrected for age in order to rule out age-related effects.

RESULTS

There was a statistically significant difference between the two groups in terms of TAMA (P < 0.05) driven by a reduction in patients with peritumoral collateral vessels. The result was confirmed by repeating the analysis with values corrected for age (P < 0.05), indicating no age effect on our findings.

CONCLUSION

This study showed a decreased TAMA in ccRCC patients with peritumoral collateral vessels. The presence of peritumoral collateral vessels adjacent to ccRCC might be a fine diagnostic clue to sarcopenia.

Keywords: Cancer cachexia; Body composition; Clear cell renal cell carcinoma; Collateral vessels; Kidney cancer; Sarcopenia

Core Tip: Clear cell renal cell carcinoma (ccRCC) can be detected with or without peritumoral collateral vessels. These vessels have been defined as enlarged capsular veins, stimulated by tumor-related effects. The presence of peritumoral collateral vessels around ccRCC is a poorly investigated phenomenon, with unclear clinical meaning. Here, we reported a novel association between peritumoral collateral vessels and loss of skeletal muscle in patients with ccRCC. The effect was not influenced by age, supporting the concept that peritumoral collateral vessels adjacent to ccRCC should drive clinicians’ attention towards cancer cachexia.