Sarcopenia and the Modified Glasgow Prognostic Score are Significant Predictors of Survival Among Patients with Metastatic Renal Cell Carcinoma Who are Receiving First-Line Sunitinib Treatment

Abstract

Background

Cancer cachexia is associated with patient outcomes.

Objective

The objective was to evaluate the effect of cachexia on survival among patients with metastatic renal cell carcinoma (mRCC) who had received first-line sunitinib treatment.

Patients and Methods

Seventy-one patients were retrospectively evaluated. Sarcopenia was diagnosed using sex-specific cut-offs for skeletal muscle index (measured using pre-treatment computed tomography) that were adjusted for body mass index. The modified Glasgow prognostic score (mGPS) was measured using C-reactive protein (CRP) and albumin levels (mGPS 2: CRP >1.0 mg/dL and albumin <3.5 g/dL; mGPS 1: CRP >1.0 mg/dL; mGPS 0: CRP ≤1.0 mg/dL). Progression-free survival (PFS) and overall survival (OS) were analyzed using the Kaplan-Meier method and Cox proportional hazard models.

Results

Forty-five patients (63.4 %) had sarcopenia, with 53 (74.6 %), ten (14.1 %), and eight (11.3 %) patients having an mGPS of 0, 1, and 2, respectively. Sarcopenia was associated with significantly inferior PFS and OS, compared to non-sarcopenic patients (PFS: 7.6 vs. 18.2 months, p = 0.0004; OS: 22.3 months vs. not reached, p = 0.0019). Higher mGPS was associated with inferior PFS and OS (mGPS 0, 1, and 2: PFS = 11.5, 10.9, and 4.12 months, p < 0.0001; OS = 47.2, not reached, and 5.28 months, p < 0.0001; respectively). Sarcopenia was an independent predictor of shorter PFS (p = 0.0163), and mGPS was an independent predictor of shorter OS (p = 0.0012).

Conclusion

Sarcopenia and mGPS can predict outcomes among patients with mRCC who are receiving first-line sunitinib treatment.

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