Sarcopenia as a comorbidity-independent predictor of survival following radical cystectomy for bladder cancer
BACKGROUND: A multicentre study was conducted to investigate the impact of sarcopenia as an independent predictor of oncological outcome after radical cystectomy for bladder cancer. - METHODS: In total, 500 patients with available digital computed tomography scans of the abdomen obtained within 90 d...
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| Main Authors: | , , , , , , , , , , , , , , |
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| Format: | Article (Journal) |
| Language: | English |
| Published: |
25 February 2018
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| In: |
Journal of cachexia, sarcopenia and muscle
Year: 2018, Volume: 9, Issue: 3, Pages: 505-513 |
| ISSN: | 2190-6009 |
| DOI: | 10.1002/jcsm.12279 |
| Online Access: | Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1002/jcsm.12279
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| Author Notes: | Roman Mayr, Michael Gierth, Florian Zeman, Marieke Reiffen, Philipp Seeger, Felix Wezel, Armin Pycha, Evi Comploj, Matteo Bonatti, Manuel Ritter, Bas W.G. van Rhijn, Maximilian Burger, Christian Bolenz, Hans-Martin Fritsche & Thomas Martini |
| Summary: | BACKGROUND: A multicentre study was conducted to investigate the impact of sarcopenia as an independent predictor of oncological outcome after radical cystectomy for bladder cancer. - METHODS: In total, 500 patients with available digital computed tomography scans of the abdomen obtained within 90 days before surgery were identified. The lumbar skeletal muscle index was measured using pre-operative computed tomography. Cancer-specific survival (CSS) and overall survival (OS) were estimated using Kaplan-Meier curves. Predictors of CSS and OS were analysed by univariable and multivariable Cox regression models. - RESULTS: Based on skeletal muscle index, 189 patients (37.8%) were classified as sarcopenic. Patients with sarcopenia were older compared with their counterparts (P = 0.002), but both groups were comparable regarding to gender, comorbidity, tumor, node, metastasis (TNM) stage, and type of urinary diversion (all P > 0.05). In total, 234 (46.8%) patients died, and of these, 145 (29.0%) died because of urothelial carcinoma of the bladder. Sarcopenic patients had significantly worse 5 year OS (38.3% vs. 50.5%; P = 0.002) and 5 year CSS (49.5% vs. 62.3%; P = 0.016) rates compared with patients without sarcopenia. Moreover, sarcopenia was associated independently with both increased all-cause mortality (hazard ratio, 1.43; 95% confidence interval 1.09-1.87; P = 0.01) and increased cancer-specific mortality (hazard ratio, 1.42; 95% confidence interval, 1.00-2.02; P = 0.048). Our results are limited by the lack of prospective frailty assessment. - CONCLUSIONS: Sarcopenia has been shown to be an independent predictor for OS and CSS in a large multicentre study with patients undergoing radical cystectomy for bladder cancer. |
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| Item Description: | Gesehen am 24.03.2020 |
| Physical Description: | Online Resource |
| ISSN: | 2190-6009 |
| DOI: | 10.1002/jcsm.12279 |