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.