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Table 2: Univariate and multivariate Cox regression analyses for prediction of progression-free survival in 268 non-metastatic cc-RCC patients treated with nephrectomy (Tumor grade was identified according to the Fuhrman grading system in the multivariable system) cc-RCC = clear-cell renal cell carcinoma; SFA = subcutaneous fat area; VFA = visceral fat area; RSFA = renal sinus fat area; BMI = body mass index; AJCC = American Joint Committee on Cancer; LNM = lymph node metastasis. Table 3: Multivariate Cox regression analyses for prediction of progression-free survival in 268 non-metastatic cc-RCC patients treated with nephrectomy (Tumor grade was identified according to the WHO/ISUP grading system) cc-RCC = clear-cell renal cell carcinoma; SFA = subcutaneous fat area; VFA = visceral fat area; RSFA = renal sinus fat area; AJCC = American Joint Committee on Cancer. Further, our analysis demonstrated that larger RSFA, lower Fuhrman and WHO/ISUP grades, lower AJCC stage and the presence of sarcomatoid component were independent predictive factors of the PFS of non-metastatic cc RCC.Leibovich scoring system used Fuhrman grade as one of the predictors.Thus, we established a prognostic nomogram with factors such as Fuhrman grade, RSFA, AJCC stage and the presence of sarcomatoid component (Figure 2).The calibration curves demonstrated good consistency in bootstrap analysis between the calculated and actual 3-year PFS (Figure 3).Many post-operative clinicopathological features are associated with overall survival of RCC patients and several predictive score models have been established to improve the risk stratification [3–5].Metabolic syndrome (MS) is one of the pre-operative parameters that have been recently reported that predict survival outcomes of RCC patients.ABSTRACT In this retrospective study, we evaluated the association between renal sinus fat area (RSFA) and survival in 268 Chinese non-metastatic clear-cell renal cell carcinoma (cc RCC) patients.Patients with high RSFA exhibited better progression-free survival than those with low RSFA in both univariable (HR: 0.240; 95% CI: 0.119–0.482; = 0.028).

We also identified 28, 57, 36 and 13 patients as grade 1, grade 2, grade 3 and grade 4 in the low RSFA group, respectively.

Two major features of MS, namely, visceral obesity and hypertension have been established as etiological factors of RCC [6–7].

However, contradictory results have been reported regarding association between visceral fat area (VFA) and the prognosis of RCC [8–13].

Recently, renal sinus fat accumulation (RSFA) or ectopic adipose tissue deposits have been associated with many MS features including hypertension [14–15]. Therefore, we studied the association between renal sinus fat area (RSFA) and the progression-free survival (PFS) of cc RCC.

In addition, we constructed a nomogram to predict the PFS of non-metastatic cc RCC.

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