Impact of Adipokine Expression on Tumor Characteristics and Survival Outcomes in Patients with Renal Cell Carcinoma

Background and Objectives: To investigate the clinical significance of adipokines' [leptin, leptin receptor (leptin-R), adiponectin, and resistin] expression on the characteristics and survival outcomes of patients with renal cell carcinoma (RCC). Materials and Methods: A total of 81 patients were included. The expressions of adipokines in the nephrectomy material of the patients were assessed using immunohistochemistry. Staining patterns were divided into two groups for statistical analyses: negative (no staining) and positive. Univariable and multivariable Cox regression models were used to evaluate the impact of the expression of adipokines on the survival outcomes of the patients. Results: The percentages of patients expressing leptin, leptin-R, adiponectin, and resistin were 36.4%, 30.7%, 32%, and 60.2%, respectively. The median overall survival (OS) of all patients was 53.7 months (95% confidence interval [CI]: 39.9-67.5). In the multivariate analyses, only leptin expression status was associated with OS among adipokines (hazard ratio [HR]: 1.98, 95%CI: 1.03-3.78, p = 0.039) in addition to the presence of distant metastasis (HR: 2.48, 95%CI: 1.16-5.29, p = 0.018). No significant associations were determined between adipokine expression and pathologic determinants of RCC, including tumor stage, grade, and histological subtype. Conclusions: Our study demonstrated that leptin expression was an independent prognostic factor for inferior OS in RCC patients treated with nephrectomy, even after adjusting for disease stage in multivariate analysis.