ArticleWorld journal of urology2026
Sarcopenia is associated with poor survival among patients with non-metastatic renal cell carcinoma and venous tumor thrombus.
Article in World journal of urology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introductionSarcopenia 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.
methodsFollowing 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.
resultsAmong 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).
conclusionsIn 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.
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