Prognostic value of body fat composition in patients with upper tract urothelial carcinoma undergoing radical nephroureterectomy.
Journal
Journal of the Formosan Medical Association
ISSN
0929-6646
Date Issued
2025-12-26
Author(s)
Abstract
Background/Purpose: To evaluate the prognostic value of body composition indices—subcutaneous adipose tissue index (SATI), visceral adipose tissue index (VATI), intramuscular adipose tissue index (IMATI), and skeletal muscle index (SMI)—in patients with upper tract urothelial carcinoma (UTUC) undergoing radical nephroureterectomy (RNU). We also assessed the impact of contrast enhancement on these indices. Methods: This retrospective, single-center study included patients who underwent preoperative abdominal computed tomography within 3 months before undergoing RNU between January 2016 and January 2020. Body composition indices were measured at T12–L5. The effect of contrast enhancement was analyzed using paired t tests. Survival outcomes (cancer-specific and overall survival) were evaluated using Kaplan–Meier curves and Cox regression models. Results: This study included 166 patients (mean age, 70 ± 9 years; men, 72). A higher SATI value was associated with better survival (hazard ratio: 0.98; p < 0.05), whereas a higher visceral fat/subcutaneous fat ratio was associated with poorer survival (hazard ratio: 1.37–3.13; p < 0.05). Contrast enhancement significantly reduced the visceral adipose tissue index and intramuscular adipose tissue index values across multiple vertebral levels (p < 0.001). Conclusion: The SATI and visceral fat/subcutaneous fat ratio are key prognostic indicators in patients with UTUC undergoing RNU. Our findings highlight the need for standardized imaging protocols to ensure accurate risk stratification and guide clinical decision-making.
Subjects
Body composition
Contrast enhancement
Multidetector computed tomography
Prognosis
Urothelial carcinoma
Publisher
Elsevier B.V.
Type
journal article