Sarcopenia is associated with poor survival among patients with non-metastatic renal cell carcinoma and venous tumor thrombus.

Authors

Reza Lahiji, Baris Esen, Luke L Son, Dattatraya Pail, Charan Koltur, Susan Mumford, Benjamin N Schmeusser, William Luke, Lorenzo Storino Ramacciotti, Ernest A Morton, Taylor A Goodstein, Adam Braunschweig, Reza Nabavizadeh, Vikram N Narayan, Valentina Grajales, Shreyas S Joshi, Mohammad Hajiha, Nazih Khater, Kenneth Ogan, Sarah P Psutka, Viraj A Master

Published in

World journal of urology. Volume 44. Issue 1. Jul 06, 2026. Epub Jul 06, 2026.

Abstract

Sarcopenia is common among patients with renal cell carcinoma (RCC) and has been associated with poor cancer-specific (CSS) and overall survival (OS). Similarly, venous tumor thrombus (VTT) carries substantial prognostic and surgical consequences. In this study, we analyze whether sarcopenia is independently associated with CSS/OS in an expanded cohort of patients with non-metastatic RCC and VTT.
Following IRB approval, adults undergoing nephrectomy for non-metastatic RCC with VTT and available imaging within 90 days of surgery were included between 2005 and 2024. Skeletal muscle index (SMI) was then calculated using axial L3 imaging segmentation and sarcopenia determined using validated SMI thresholds. Multivariable COX proportional hazards models analyzed factors independently associated with 5-year CSS and OS.
Among 135 patients, 39 (28.9%) were sarcopenic. Sarcopenic patients were older, had lower BMIs and higher rates of Fuhrman grade 4 disease (all p < 0.01). On multivariable analysis, sarcopenia was independently associated with poor 5-year CSS (HR 4.04, 1.82-8.95, p = < 0.001) and OS (HR 2.60, 95%CI 1.41-4.79, p = 0.002). Analyzing SMI revealed protective effects with per-unit increases in skeletal muscle for both 5-year CSS (HR 0.94, 95%CI 0.91-0.98, p = 0.001) and OS (HR 0.96, 95%CI 0.93-0.99, p = 0.005).
In this study utilizing the largest number of non-metastatic RCC patients with VTT, sarcopenia maintained an independent association with worse 5-year CSS and OS. Expectedly, increases in skeletal muscle/SMI were independently associated with improved survival.

PMID:
42406172
Bibliographic data and abstract were imported from PubMed on 06 Jul 2026.

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