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. 2011;16(1):71-81.
doi: 10.1634/theoncologist.2010-0227. Epub 2011 Jan 6.

Visceral fat area as a new independent predictive factor of survival in patients with metastatic renal cell carcinoma treated with antiangiogenic agents

Sylvain Ladoire  1 , Franck Bonnetain, Mélanie Gauthier, Sylvie Zanetta, Jean Michel Petit, Séverine Guiu, Isabelle Kermarrec, Eric Mourey, Frederic Michel, Denis Krause, Patrick Hillon, Luc Cormier, François Ghiringhelli, Boris Guiu
Affiliations

Visceral fat area as a new independent predictive factor of survival in patients with metastatic renal cell carcinoma treated with antiangiogenic agents

Sylvain Ladoire et al. Oncologist. 2011.

Abstract

Purpose. A better identification of patients who are more likely to benefit from vascular endothelial growth factor-targeted therapy is warranted in metastatic renal cell carcinoma (mRCC). As adipose tissue releases angiogenic factors, we determined whether parameters such as visceral fat area (VFA) were associated with outcome in these patients. Experimental Design. In 113 patients with mRCC who received antiangiogenic agents (bevacizumab, sunitinib, or sorafenib) (n = 64) or cytokines (n = 49) as first-line treatment, we used computed tomography to measure VFA and subcutaneous fat area (SFA). We evaluated associations linking body mass index (BMI), SFA, and VFA to time to progression (TTP) and overall survival (OS). Results. High SFA and VFA values were significantly associated with shorter TTP and OS. By multivariate analysis, high VFA was independently associated with shorter TTP and OS. These results were internally validated using bootstrap analysis. By contrast, VFA was not associated with survival in the cytokine group. In the whole population, interaction between VFA and treatment group was significant for TTP and OS, thereby confirming the results. Conclusion. Our study provides the first evidence that high VFA could be a predictive biomarker from shorter survival in patients given first-line antiangiogenic agents for mRCC.

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Conflict of interest statement

Disclosures: Sylvain Ladoire: None; Franck Bonnetain: None; Mélanie Gauthier: None; Sylvie Zanetta: None; Jean Michel Petit: None; Séverine Guiu: None; Isabelle Kermarrec: None; Eric Mourey: None; Frederic Michel: None; Denis Krause: None; Patrick Hillon: None; Luc Cormier: None; François Ghiringhelli: None; Boris Guiu: None

The content of this article has been reviewed by independent peer reviewers to ensure that it is balanced, objective, and free from commercial bias. No financial relationships relevant to the content of this article have been disclosed by the authors or independent peer reviewers.

Figures

Figure 1.
Figure 1.
Measurement of visceral and subcutaneous fat area. (A) Computed tomography, axial section through the umbilicus in a 72 year old woman. (B) Visceral fat area (VFA) (in white) was 7208 mm2 (lower than the median in the overall population). (C) Subcutaneous fat area (SFA) (in white) was 21,541 mm2 (higher than the median in the overall population).
Figure 2.
Figure 2.
For each of the two groups—cytokine group (top) and antiangiogenic group (bottom)—TTP was compared according to SFA (left) and VFA (right) dichotomized to the median (Kaplan-Meier estimates). Abbreviations: SFA, subcutaneous fat area; TTP, time to progression; VFA, visceral fat area.
Figure 3.
Figure 3.
For each of the two groups—cytokine group (top) and antiangiogenic group (bottom)—OS was compared according to SFA (left) and VFA (right) dichotomized to the median (Kaplan-Meier estimates). Abbreviations: OS, overall survival; SFA, subcutaneous fat area; VFA, visceral fat area.
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