The Role of Obesity in Renal Cell Carcinoma Patients: Clinical-Pathological Implications

• Published in: International journal of molecular sciences Vol. 20; no. 22; p. 5683
• Main Authors: Aurilio, Gaetano, Piva, Francesco, Santoni, Matteo, Cimadamore, Alessia, Sorgentoni, Giulia, Lopez-Beltran, Antonio, Cheng, Liang, Battelli, Nicola, Nolè, Franco, Montironi, Rodolfo
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 13.11.2019; MDPI
• Subjects: 1-Phosphatidylinositol 3-kinase; Adipocytes; Adiponectin; Adipose tissue; AKT protein; Angiogenesis; Animals; Apoptosis; Body mass index; Body size; Body weight; Breast cancer; Carcinogenesis; Carcinogens; Carcinoma, Renal Cell - complications; Carcinoma, Renal Cell - diagnosis; Carcinoma, Renal Cell - pathology; Carcinoma, Renal Cell - therapy; Cell growth; Ceruloplasmin; Chemokines; Crosstalk; Cyclin D1; Cytokines; Disease; Extracellular matrix; Gene expression; Growth factors; Health services; Humans; Immune system; Immunotherapy; Inflammation; Insulin; Insulin receptor substrate 1; Insulin receptors; Insulin-like growth factors; Interleukin 6; Kidney cancer; Kidney Neoplasms - complications; Kidney Neoplasms - diagnosis; Kidney Neoplasms - pathology; Kidney Neoplasms - therapy; Medical prognosis; Metabolites; Metastasis; Molecular Targeted Therapy; Mutation; Obesity; Obesity - complications; Obesity - pathology; Patients; Polypeptides; Prognosis; Renal cell carcinoma; Review; Steroids; Treatment Outcome; Tumor necrosis factor-TNF; Vascular endothelial growth factor; United States > US; targeted therapy; clinical outcomes; renal cell carcinoma; body mass index; obesity; immunotherapy
• ISSN: 1422-0067; 1661-6596; 1422-0067
• DOI: 10.3390/ijms20225683

Obesity is a well-known risk factor for renal cell carcinoma (RCC) development. However, the RCC-obesity link has not been fully addressed when considering a comprehensive scenario starting from pathogenetic aspects through pathological issues up to the outcome of medical treatment. We therefore conducted an electronic PubMed search using keywords "obesity", "body mass index", "overweight", "renal cell carcinoma/kidney cancer", "medical treatment", "targeted therapy", and "immunotherapy/immune checkpoint inhibitors". The selected data supported a crosstalk between adipose tissue (adipocytes and other white adipose tissue cells) and cancer cells inducing several signaling pathways that finally stimulated angiogenesis, survival, and cellular proliferation. Accurate sampling of renal sinus fat correlated with a prognostic value. Retrospective clinical evidence in metastatic RCC patients with higher body mass index (BMI) and treated with targeted therapies and/or immune checkpoint inhibitors showed advantageous survival outcomes. Therefore, obesity may influence the course of RCC patients, although the interplay between obesity/BMI and RCC warrants a large prospective confirmation. We are therefore still far from determining a clear role of obesity as a prognostic/predictive factor in metastatic RCC patients undergoing targeted therapy and immunotherapy.