Role of the androgen, estrogen, and progesterone receptors in adherent perinephric fat in robotic partial nephrectomy

To determine whether androgen, estrogen, and/or progesterone signaling play a role in the pathophysiology of adherent perinephric fat (APF). We prospectively recruited patients undergoing robotic assisted partial nephrectomy during 2015–2017. The operating surgeon documented the presence or absence...

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Bibliographic Details
Published in:Journal of robotic surgery 2022-02, Vol.16 (1), p.143-148
Main Authors: Du, Kefu, Potretzke, Aaron M., Rais, Rehan, Anderson, Barrett G., Han, Christopher S., Kim, Eric H., Benabdallah, Justin, Jalaly, Jalal, Vetter, Joel M., Paradis, Alethea G., Palka, Joshua K., Venkatesh, Ramakrishna, Figenshau, R. Sherburne
Format: Article
Language:English
Subjects:
Androgens
Body mass index
Carcinoma, Renal Cell - surgery
Comorbidity
Diabetes
Diabetes mellitus
Estrogens
Gender equity
Histology
Humans
Kidney cancer
Kidney Neoplasms - pathology
Kidney Neoplasms - surgery
Medicine
Medicine & Public Health
Minimally Invasive Surgery
Monoclonal antibodies
Nephrectomy
Original Article
Patients
Receptors
Receptors, Progesterone
Retrospective Studies
Robotic Surgical Procedures - methods
Robotics
Sex hormones
Surgery
Treatment Outcome
Tumors
Urology
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Summary:To determine whether androgen, estrogen, and/or progesterone signaling play a role in the pathophysiology of adherent perinephric fat (APF). We prospectively recruited patients undergoing robotic assisted partial nephrectomy during 2015–2017. The operating surgeon documented the presence or absence of APF. For those with clear cell renal cell carcinoma (ccRCC), representative sections of tumor and perinephric fat were immunohistochemically stained with monoclonal antibody to estrogen α, progesterone, and androgen receptors. Patient characteristics, operative data, and hormone receptor presence were compared between those with and without APF. Of 51 patients total, 18 (35.3%) and 33 (64.7%) patients did and did not have APF, respectively. APF was associated with history of diabetes mellitus (61.1% vs 24.2%, p  = 0.009) and larger tumors (4.0 cm vs 3.0 cm, p  = 0.017) but not with age, gender, BMI, Charleston comorbidity index, smoking, or preoperative estimated glomerular filtration rate. APF was not significantly associated with length of operation, positive margins, or 30-day postoperative complications but incurred higher estimated blood loss (236.5 mL vs 209.2 mL, p  = 0.049). Thirty-two had ccRCC and completed hormone receptor staining. The majority of tumors and perinephric fat were negative for estrogen and progesterone while positive for androgen receptor expression. There was no difference in hormone receptor expression in either tumor or perinephric fat when classified by presence or absence of APF ( p  > 0.05). APF is more commonly present in patients with diabetes or larger tumors but was not associated with differential sex hormone receptor expression in ccRCC.
ISSN:1863-2483
1863-2491
DOI:10.1007/s11701-021-01225-4