The Association of Metabolic Syndrome and Renal Cell Carcinoma: Report on 42 Cases
MP Alexander, LA Watts, J Gan. Boston University Medical Centre, Boston, MA
Background: The prevalence of Metabolic Syndrome (MS) in the United States is increasing, affecting almost a third of the US adult population. There has been great interest in research related to MSand its pro-inflammatory state. In the more recent past there have been associations drawn between MS and cancers such as ovary and prostate. The association between MS and renal cell carcinomas is so far unpublished. In this study we sought to examine the association between MS and the histological parameters of Renal Cell Carcinoma.
Design: We retrospectively screened clinical information for 42 patients who underwent elective nephrectomy for renal cell carcinoma between January 2006 to December 2007. MS was defined using National Cholesterol Education Program ATP III guidelines. According to these guidelines, the diagnosis of metabolic syndrome is based on the presence of abnormalities of any 3 of the following criteria: abdominal obesity, serum triglyceride levels of 150mg/dl or greater or drug treatment for increased triglyceride level; serum HDL-C level less than 40mg/dl in men and less than 50mg/dL in women or drug treatment for low HDL-C level; BP of 130/85 mm Hg or greater or drug treatment for increased BP; and fasting plasma glucose level of 110mg/dl or greater or drug treatment for increased blood glucose level. Twenty one cases fulfilled the criterion for MS, and seventeen of the cases served as controls as they has one or less of the criterion for MS. In four cases there was inadequate clinical information. The two groups were compared for demography, tumor size, tumor morphology, Fuhrman nuclear grade and pathological staging.
Results: MS was prevalent in 55% of RCC. The two groups were comparable with regards to age at presentation and gender distribution. African Americans with renal cell carcinoma had a higher prevalence of MS (66%). Wile comparing the two groups, those with MS as compared to those without MS had larger tumors (4.7cm vs 3.1 cm), higher Fuhrman nuclear grade (33% vs 0%) and more advanced AJCC pathological stage (2 and 3) at presentation (33% vs 12%).
Conclusions: Although limited by the small sample size this study highlights a trend. In keeping with the epidemic spread of MS world wide, we find a high prevalence of MS in those with RCC. The significance of this is reflected in our study where in those with the MS had adverse pathology parameters. The biological basis of this could be ascribed to inflammation, reactive oxygen species activation and growth factor regulation.
Category: Genitourinary (including renal tumors)
Tuesday, March 23, 2010 9:30 AM
Poster Session III # 167, Tuesday Morning