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Dergiler / Endoüroloji Bülteni / 2025 / Cilt: 17 Sayı: 3

Lokalize Renal Hücreli Karsinomu Olan Hastalarda Psoas Kas İndeksi ve İskelet Kas İndeksine Dayalı Kas Kütlesinin Nüks ve Mortalite Riski ile İlişkisi: Kapsamlı Bir Retrospektif Analiz

Relationship of Muscle Mass Based on Psoas Muscle Index and Skeletal Muscle Index with Recurrence and Mortality Risk in Localized Renal Cell Carcinoma: A Comprehensive Retrospective Analysis

Yusuf Arıkan(UNIVERSITY OF HEALTH SCIENCES, İZMİR TEPECİK HEALTH RESEARCH CENTER, DEPARTMENT OF SURGICAL MEDICAL SCIENCES, THE DEPARTMENT OF UROLOGY)0000-0003-0823-7400
Deniz Noyan Özlü(Bitlis State Hospitali Urology)0000-0003-2435-5482
Büşra Emir(IZMIR KATIP CELEBI UNIVERSITY, KATİP ÇELEBİ APPLICATION AND RESEARCH CENTER)0000-0003-4694-1319
Hakan Polat(UNIVERSITY OF HEALTH SCIENCES, İSTANBUL BAKIRKÖY DR. SADİ KONUK TRAINING RESEARCH CENTER, DEPARTMENT OF SURGICAL MEDICAL SCIENCES, THE DEPARTMENT OF UROLOGY)0000-0003-1525-1243
Mehmet Zeynel Keskin(UNIVERSITY OF HEALTH SCIENCES, İZMİR TEPECİK HEALTH RESEARCH CENTER)0000-0002-9206-5586
Sayfa
119–131
Yayın Tarihi
2025-09-30
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⚡ TL;DR(1 Cümlede Hızlı Çıkarım)

Bulgular: ROC analizinde, PMI için optimal kesim değeri sırasıyla erkek ve kadın hastalarda ≤ 5,1 cm²/m² ve ≤ 3,1 cm²/m² iken, SMI için kesim değeri erkek ve kadın hastalarda ≤ 44 cm²/m² ve ≤ 30 cm²/m² idi.

📌 3 Maddede Bu Makale

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Amaç & Hipotez:Amaç: Lokalize Renal Hücreli Karsinomlu (RHK) hastalarda Psoas Kas İndeksi (PMI) ve İskelet Kas İndeksi (SMI) ile nüks ve mortalite riski arasındaki ilişkiyi belirlemeyi amaçladık.
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Temel Bulgular & Veri:Gereç ve Yöntemler: SMI ve PMI değerleri, L3 seviyesindeki kesitlerde kontrastsız bilgisayarlı tomografi (BT) ölçümlerinden elde edildi ve yüksekliğe göre normalize edildi.
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Sonuç & Katkı:Bulgular: ROC analizinde, PMI için optimal kesim değeri sırasıyla erkek ve kadın hastalarda ≤ 5,1 cm²/m² ve ≤ 3,1 cm²/m² iken, SMI için kesim değeri erkek ve kadın hastalarda ≤ 44 cm²/m² ve ≤ 30 cm²/m² idi.
🔬Tür:Araştırma Makalesi
📍Kapsam:Genişletilmiş Akademik Örneklem
⚙️Değişkenler:iskelet kası indeksi · psoas kas indeksi · renal hücreli karsinom

Özet

Amaç: Lokalize Renal Hücreli Karsinomlu (RHK) hastalarda Psoas Kas İndeksi (PMI) ve İskelet Kas İndeksi (SMI) ile nüks ve mortalite riski arasındaki ilişkiyi belirlemeyi amaçladık. Gereç ve Yöntemler: SMI ve PMI değerleri, L3 seviyesindeki kesitlerde kontrastsız bilgisayarlı tomografi (BT) ölçümlerinden elde edildi ve yüksekliğe göre normalize edildi. Genel sağkalım (OS) ve nükssüz sağkalım (RFS) dahil olmak üzere mevcut sağkalım verileri ameliyat sonrası takipte toplandı. Hastalık nüksü BT, manyetik rezonans görüntüleme veya kemik taramasında hastalığın radyografik kanıtı olarak tanımlanmıştır. Bulgular: ROC analizinde, PMI için optimal kesim değeri sırasıyla erkek ve kadın hastalarda ≤ 5,1 cm²/m² ve ≤ 3,1 cm²/m² iken, SMI için kesim değeri erkek ve kadın hastalarda ≤ 44 cm²/m² ve ≤ 30 cm²/m² idi. Çok değişkenli analizlerde, kadın cinsiyet, nüks, klinik T evresi ≥ T3b, patolojik T evresi ≥T3b ve PMI ve SMI’ye göre sarkopeni daha kötü OS ve RFS’nin bağımsız belirleyicileriydi (p<0,001). Kaplan-Meier analizinde, sarkopenisi olan ve olmayan hastalarda OS sırasıyla 74 vs 85 ay saptandı (p<0,001). RFS sarkopenisi olan hastalarda daha kısaydı (PMI: 76 vs 84, SMI: 74 vs 85 ay, her ikisi de p<0,001) Sonuç: Lokalize RHK’li hastalarda sarkopeni daha erken nüks, daha kısa OS ve RFS ile ilişkiliydi. Sarkopenisi olan hastalar preoperatif evrelemede daha kötü prognoza sahipti.

Abstract

Objective: We aimed to determine the relationship between the Psoas Muscle Index (PMI) and Skeletal Muscle Index (SMI) and the risk of recurrence and mortality in patients with localized Renal Cell Carcinoma (RCC). Material and Methods: SMI and PMI values were obtained from non-contrast computed tomography (NCCT) measurements on slices at the L3 level, normalized by height. Available survival data, including overall survival (OS) and recurrence-free survival (RFS), were collected at postoperative follow-up. Disease recurrence was defined as radiological evidence of disease on computed tomography (CT), magnetic resonance imaging, or bone scan. Results: In the ROC analysis, the optimal cut-off value for PMI was ≤ 5.1 cm²/m² and ≤ 3.1 cm²/m² in male and female patients, while the cut-off value for SMI was ≤ 44 cm²/m² and ≤ 30 cm²/m² in male and female patients. In multivariate analyses, female gender, recurrence, clinical T stage ≥ T3b, pathological T stage ≥T3b, and sarcopenia according to PMI and SMI were independent predictors of worse OS and RFS (p < 0.001). In Kaplan-Meier analysis, OS in patients with and without sarcopenia was 74 vs 85 months (p < 0.001), respectively. RFS were shorter in patients with sarcopenia (PMI: 76 vs 84, SMI: 74 vs 85 months, both p < 0.001) Conclusion: In patients with localized RCC, sarcopenia was associated with earlier recurrence, shorter OS, and RFS. Patients with sarcopenia had a worse prognosis in preoperative staging.

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Bu Makaleye Atıf Yap

Arıkan, Y., Özlü, D. N., Emir, B., Polat, H., Keskin, M. Z. (2025). Lokalize Renal Hücreli Karsinomu Olan Hastalarda Psoas Kas İndeksi ve İskelet Kas İndeksine Dayalı Kas Kütlesinin Nüks ve Mortalite Riski ile İlişkisi: Kapsamlı Bir Retrospektif Analiz. Endoüroloji Bülteni, Cilt: 17 Sayı: 3, 119–131. https://doi.org/10.54233/endourolbull-1704160

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