Preoperative and postoperative risk prediction models based on perirenal fat and immune infiltration for small renal tumors: A multicenter cohort study.

• DOI: 10.1200/jco.2025.43.16_suppl.e16514
• Publication Date: 2025-05-28T14:53:59Z
• Authors: Xingang Cui; Xiuwu Pan; Tianyue Yang; Muchen Li; Bingnan Lu; Keqin Dong; Wang Zhou
• Keywords: Infiltration (HVAC)

e16514 Background: The obesity paradox in clear cell renal carcinoma (ccRCC) has drawn attention, with studies suggesting perirenal fat may serve as an immune reservoir, influencing the tumor microenvironment and prognosis. However, its specificity clinical relevance compared to BMI remain uncertain, prognostic utility patient management is underexplored. This study evaluates significance of thickness (PRFT) potential improve prediction models, particularly for small tumors (≤4 cm). Methods: PRFT was measured categorized a multicenter cohort 620 ccRCC patients, association survival analyzed. Immune infiltration assessed using single-cell RNA sequencing multiplex immunofluorescence. Correlations between were explored. Prognostic models developed Results: Tumor-side clustering demonstrated superior value over BMI. Reduced tumor-side correlated increased exhausted CD8+ T cells (CD8E). integrating showed strong predictive performance progression-free survival, aiding preoperative risk assessment postoperative management. Limitations include reliance on data lack external validation. Conclusions: Perirenal promising marker, By into we have personalized systematic approach treatment decision-making early-stage tumors, providing practical framework improved tailored strategies. Performance comparison models: 10-fold cross-validation time-dependent AUC analysis. Model/AUC Fold1 Fold2 Fold3 Fold4 Fold5 Fold6 Fold7 Fold8 Fold9 Fold10 Mean Full model 3-years 4-years 5-years 6-years Preoperative FATe-Surg(Our model) 0.62 0.71 0.82 0.69 0.86 0.85 0.64 0.78 0.74 0.80 0.81 Age 0.50 0.59 0.84 0.66 0.57 0.79 0.58 0.68 0.73 0.77 Size 0.56 0.41 0.23 0.28 0.48 0.54 0.51 0.25 0.45 0.55 0.47 Age+Size 0.83 0.60 0.72 Postoperative FATe-Follow(Our 0.63 0.65 0.75 SSIGN Suspicion high collinearity, unable perform cross-validation. 0.53 Age+SSIGN