Andreas M Hötker1, Christoph A Karlo2, Pier Luigi Di Paolo3, Junting Zheng4, Chaya S Moskowitz4, Paul Russo5, Hedvig Hricak6, Oguz Akin6. 1. University Hospital Zurich, Institute of Diagnostic and Interventional Radiology, Rämistrasse 100, 8091, Zurich, Switzerland. Electronic address: Andreas.Hoetker@usz.ch. 2. Hirslanden Clinic, Witellikerstrasse 40, 8032, Zurich, Switzerland. 3. Bambino Gesù Children's Hospital, Department of Radiology, Piazza Sant'Onofrio 4, 00165, Rome, Italy. 4. Memorial Sloan-Kettering Cancer Center, Department of Epidemiology and Biostatistics, 1275 York Avenue New York, NY 10065 USA. 5. Memorial Sloan-Kettering Cancer Center, Department of Surgery, Urology Service, 1275 York Avenue, New York, NY 10065 USA. 6. Memorial Sloan-Kettering Cancer Center, Department of Radiology, 1275 York Ave New York, NY 10065, USA.
Abstract
PURPOSE: To investigate associations between imaging features of tumors and age, gender and body mass index (BMI) in patients with renal cell carcinoma. METHOD: This IRB-approved, HIPAA-compliant study included 1348 patients with histopathologically confirmed renal cell carcinoma of the clear cell subtype (ccRCC, n = 904) or non-clear cell subtype (n = 444), who underwent pre-treatment CT imaging less than 180 days before nephrectomy between 1999 and 2011. Two radiologists independently, retrospectively analyzed all imaging studies and identified features (necrosis, renal vein invasion, contact with renal sinus fat, multicystic appearance and nodular enhancement), which were then correlated with patient age, gender and BMI at time of surgery. RESULTS: Inter-reader agreement on imaging features ranged from substantial to excellent (kappa: 0.688 to 0.982). In the ccRCC group, multicystic tumor appearance was significantly associated with lower patient age (p < 0.05) and lower BMI (p < 0.05); the presence of renal vein invasion was significantly associated with lower BMI in males (p < 0.05); and both tumor contact with the renal sinus and nodular enhancement were significantly associated with greater patient age (p < 0.05). In the non-clear cell RCC group, necrosis was associated with lower BMI for females (p < 0.05). CONCLUSIONS: This study demonstrated significant associations between imaging features of RCC and patient age and BMI, hinting an influence of these factors on tumor biology and genomic make-up. These findings could aid future studies in selecting patients while investigating genomic, molecular and metabolic variables in RCC and might potentially impact on future stratification and therapy of patients.
PURPOSE: To investigate associations between imaging features of tumors and age, gender and body mass index (BMI) in patients with renal cell carcinoma. METHOD: This IRB-approved, HIPAA-compliant study included 1348 patients with histopathologically confirmed renal cell carcinoma of the clear cell subtype (ccRCC, n = 904) or non-clear cell subtype (n = 444), who underwent pre-treatment CT imaging less than 180 days before nephrectomy between 1999 and 2011. Two radiologists independently, retrospectively analyzed all imaging studies and identified features (necrosis, renal vein invasion, contact with renal sinus fat, multicystic appearance and nodular enhancement), which were then correlated with patientage, gender and BMI at time of surgery. RESULTS: Inter-reader agreement on imaging features ranged from substantial to excellent (kappa: 0.688 to 0.982). In the ccRCC group, multicystic tumor appearance was significantly associated with lower patientage (p < 0.05) and lower BMI (p < 0.05); the presence of renal vein invasion was significantly associated with lower BMI in males (p < 0.05); and both tumor contact with the renal sinus and nodular enhancement were significantly associated with greater patientage (p < 0.05). In the non-clear cell RCC group, necrosis was associated with lower BMI for females (p < 0.05). CONCLUSIONS: This study demonstrated significant associations between imaging features of RCC and patientage and BMI, hinting an influence of these factors on tumor biology and genomic make-up. These findings could aid future studies in selecting patients while investigating genomic, molecular and metabolic variables in RCC and might potentially impact on future stratification and therapy of patients.
Authors: Ahmed Ballati; Zakaria Essaidi; Saad Rifki El Jai; Amal Hajri; Driss Errguibi; Rachid Boufettal; Farid Chehab Journal: Ann Med Surg (Lond) Date: 2021-07-28