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Title: Obstructive sleep apnea and Fuhrman grade in patients with clear cell renal cell carcinoma treated surgically
Author: Vilaseca, Antoni
Nguyen, Daniel P.
Vertosick, Emily A.
Corradi, Renato B.
Musquera i Felip, Mireia
Pérez, Meritxell
Fossati, Nicola
Sjoberg, Daniel D.
Farré Ventura, Ramon
Almendros López, Isaac
Montserrat Canal, José Ma.
Benfante, Nicole E.
Hakimi, A.Ari
Skanderup, Anders J.
Russo, Paul
Alcaraz Asensio, Antonio
Touijer, Karim A.
Keywords: Síndromes d'apnea del son
Càncer de ronyó
Malalties del ronyó
Sleep apnea syndromes
Renal cancer
Kidney diseases
Issue Date: 1-Jan-2017
Publisher: Springer Verlag
Abstract: PURPOSE: To assess the association between obstructive sleep apnea (OSA) and Fuhrman grade in patients with clear cell renal cell carcinoma (ccRCC). As secondary endpoints, we studied its association with tumor size, metastasis-free survival (MFS) and cancer-specific survival (CSS). METHODS: We reviewed the databases of two tertiary care centers, identifying 2579 patients who underwent partial or radical nephrectomy for ccRCC between 1991 and 2014. Descriptive statistics were used to compare pathologic variables between patients with and without OSA. Linear and logistic regression models were used to assess the association of OSA with Fuhrman grade and tumor size. A Cox proportional hazards model was used to determine OSA association with MFS and CSS. A pathway analysis was performed on a cohort with available gene expression data. RESULTS: In total, 172 patients (7 %) had self-reported OSA at diagnosis. More patients with OSA had high Fuhrman grade compared to those without OSA [51 vs. 38 %; 13 % risk difference; 95 % confidence interval (CI), 5-20 %; p = 0.003]. On multivariable analysis, the association remained significant (OR 1.41; 95 % CI 1.00-1.99; p = 0.048). OSA was not associated with tumor size (p > 0.5), MFS (p = 0.5) or CSS (p = 0.4). A trend toward vascular endothelial growth factor pathway enrichment was seen in OSA patients (p = 0.08). CONCLUSIONS: OSA is associated with high Fuhrman grade in patients undergoing surgery for ccRCC. Pending validation of this novel finding in further prospective studies, it could help shape future research to better understand etiological mechanisms associated.
Note: Versió postprint del document publicat a:
It is part of: World Journal of Urology, 2017, vol. 35, num. 1, p. 51-56
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ISSN: 0724-4983
Appears in Collections:Articles publicats en revistes (Cirurgia i Especialitats Medicoquirúrgiques)
Articles publicats en revistes (Biomedicina)

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