Urologic oncology · 2026
Circulating KIM-1 and survival outcomes in renal cell carcinoma: A systematic review and meta-analysis.
СтатьяСистематический обзорМетаанализНазвание и аннотация: Перевод в очереди
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Lu Jiafu, Luo Bo, Xue Chao, Shen Jinhai
Аннотация
BACKGROUND: Renal cell carcinoma (RCC) exhibits substantial clinical heterogeneity, and conventional clinicopathological models have limited ability to provide precise individualized risk stratification. Circulating kidney injury molecule-1 (KIM-1) is an emerging, minimally invasive biomarker with potential prognostic relevance in RCC. However, existing studies have reported inconsistent findings. This meta-analysis aimed to systematically synthesize current evidence and clarify the prognostic significance of circulating KIM-1 in RCC.
METHODS: A systematic review and meta-analysis was conducted in accordance with PRISMA 2020 guidelines. Studies evaluating the association between circulating KIM-1 levels and survival outcomes in RCC were included. Pooled hazard ratios (HRs) with 95% confidence intervals (CIs) were estimated using random-effects models. Predefined subgroup analyses stratified by disease setting and KIM‑1 quantification method were conducted to explore potential sources of heterogeneity. Leave-one-out sensitivity analysis and publication bias assessment were also implemented.
RESULTS: A total of 7 studies encompassing 8 independent cohorts with 2,415 RCC patients were included. Elevated circulating KIM‑1 was significantly associated with worse overall survival (OS; HR = 1.70, 95% CI: 1.22-2.35), progression‑free survival (PFS; HR = 1.34, 95% CI: 1.05-1.72), and disease‑free survival (DFS; HR = 1.72, 95% CI: 1.45-2.04). Subgroup analyses demonstrated consistent prognostic effects across localized/adjuvant and advanced/metastatic disease settings, as well as categorical and continuous KIM‑1 detection strategies. Sensitivity analyses generally supported the direction of the associations, although variability was observed across individual studies.
CONCLUSION: Elevated circulating KIM-1 is associated with adverse survival outcomes in RCC; however, given the heterogeneity of included cohorts and limited certainty of evidence, these findings should be considered exploratory and require further prospective validation.
METHODS: A systematic review and meta-analysis was conducted in accordance with PRISMA 2020 guidelines. Studies evaluating the association between circulating KIM-1 levels and survival outcomes in RCC were included. Pooled hazard ratios (HRs) with 95% confidence intervals (CIs) were estimated using random-effects models. Predefined subgroup analyses stratified by disease setting and KIM‑1 quantification method were conducted to explore potential sources of heterogeneity. Leave-one-out sensitivity analysis and publication bias assessment were also implemented.
RESULTS: A total of 7 studies encompassing 8 independent cohorts with 2,415 RCC patients were included. Elevated circulating KIM‑1 was significantly associated with worse overall survival (OS; HR = 1.70, 95% CI: 1.22-2.35), progression‑free survival (PFS; HR = 1.34, 95% CI: 1.05-1.72), and disease‑free survival (DFS; HR = 1.72, 95% CI: 1.45-2.04). Subgroup analyses demonstrated consistent prognostic effects across localized/adjuvant and advanced/metastatic disease settings, as well as categorical and continuous KIM‑1 detection strategies. Sensitivity analyses generally supported the direction of the associations, although variability was observed across individual studies.
CONCLUSION: Elevated circulating KIM-1 is associated with adverse survival outcomes in RCC; however, given the heterogeneity of included cohorts and limited certainty of evidence, these findings should be considered exploratory and require further prospective validation.