由于乳头状肾细胞癌（pRCC）亚分类的取消，局部pRCC手术治疗后的生存预后变得不充分。肌肉减少症被广泛评估并被证明是肾细胞癌患者预后的预测因素。因此，我们全面调查了局部pRCC的身体成分参数的生存预测。纳入2012年2月至2022年2月我中心病理诊断为pRCC的患者。通过术前计算机断层扫描（CT）图像测量身体成分参数，包括骨骼肌指数（SMI）、皮下脂肪组织（SAT）和肾周脂肪组织（PRAT）。主要结局设定为无进展生存期（PFS），并使用接受者操作特征曲线（ROC）曲线的Youden计算身体成分参数的截止值。进行单变量和多变量 Cox 比例回归分析，以探索生存预测的独立危险因素。然后，使用重要因素构建预后列线图。列线图的性能通过 Harrell 的 C 指数、校准曲线和时间依赖性 ROC 曲线进行评估。共有 105 名患者入组进行分析。中位随访时间为 30.48 个月，25 名患者（23.81%）出现癌症进展。肌少症比例为74.29%。单变量 Cox 分析发现，性别、PRAT、SAT、骨骼肌 (SM)、肌肉减少症、手术技术和肿瘤直径与进展相关。进一步的多变量分析显示，肌肉减少症（风险比[HR] 0.15，95%置信区间[CI] 0.03-0.66）、SAT（HR 6.36，95% CI 2.39-16.93）、PRAT（HR 4.66，95% CI 1.77-12.27） ）、肿瘤直径（HR 0.35，95% CI 0.14-0.86）和手术技术（HR 2.85，95% CI 1.06-7.64）是癌症进展的独立危险因素。然后，构建了基于独立危险因素的预后列线图，进展预测的C指数为0.831（95％CI 0.761-0.901），代表了合理的区分，校准曲线和时间依赖性ROC曲线验证了良好的效果。构建了预后列线图，包括肌少症、SAT、PRAT、肿瘤直径和手术技术，用于计算局部 pRCC 患者的进展概率，并需要在未来的临床使用中进一步进行外部验证。© 2024。肿瘤外科学会。

Because of to the removal of subclassification of papillary renal cell carcinoma (pRCC), the survival prognostification of localized pRCC after surgical treatment became inadequate. Sarcopenia was widely evaluated and proved to be a predictive factor for prognosis in RCC patients. Therefore, we comprehensively investigated the survival prediction of the body composition parameters for localized pRCC.Patients pathologically diagnosed with pRCC between February 2012 and February 2022 in our center were enrolled. The body composition parameters, including skeletal muscle index (SMI), subcutaneous adipose tissue (SAT), and perirenal adipose tissue (PRAT), were measured by the images of preoperative computed tomography (CT). The primary outcome was set as progression-free survival (PFS), and the cutoff values of body composition parameters were calculated by using the Youden from receiver operating characteristic curve (ROC) curves. Univariate and multivariate Cox proportional regression analyses were performed to explore independent risk factors for survival prediction. Then, significant factors were used to construct a prognostic nomogram. The performance of the nomogram was evaluated by Harrell's C-index, calibration curves and time-dependent ROC curves.A total of 105 patients were enrolled for analysis. With a median follow-up time of 30.48 months, 25 (23.81%) patients experienced cancer progression. The percentage of sarcopenia was 74.29%. Univariate Cox analysis identified that gender, PRAT, SAT, skeletal muscle (SM), sarcopenia, surgical technique, and tumor diameter were associated with progression. Further multivariate analysis showed that sarcopenia (hazard ratio [HR] 0.15, 95% confidence interval [CI] 0.03-0.66), SAT (HR 6.36, 95% CI 2.39-16.93), PRAT (HR 4.66, 95% CI 1.77-12.27), tumor diameter (HR 0.35, 95% CI 0.14-0.86), and surgical technique (HR 2.85, 95% CI 1.06-7.64) were independent risk factors for cancer progression. Then, a prognostic nomogram based on independent risk factors was constructed and the C-index for progression prediction was 0.831 (95% CI 0.761-0.901), representing a reasonable discrimination, the calibration curves, and the time-dependent ROC curves verified the good performance of the nomogram.A prognostic nomogram, including sarcopenia, SAT, PRAT, tumor diameter, and surgical technique, was constructed to calculate the probability of progression for localized pRCC patients and needs further external validation for clinical use in the future.© 2024. Society of Surgical Oncology.