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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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Hauptverfasser: Mayr, Roman (VerfasserIn) , Gierth, Michael (VerfasserIn) , Zeman, Florian (VerfasserIn) , Reiffen, Marieke (VerfasserIn) , Seeger, Philipp (VerfasserIn) , Wezel, Felix (VerfasserIn) , Pycha, Armin (VerfasserIn) , Comploj, Evi (VerfasserIn) , Bonatti, Matteo (VerfasserIn) , Ritter, Manuel (VerfasserIn) , van Rhijn, Bas W. G. (VerfasserIn) , Burger, Maximilian (VerfasserIn) , Bolenz, Christian (VerfasserIn) , Fritsche, Hans-Martin (VerfasserIn) , Martini, Thomas (VerfasserIn)
Dokumenttyp: Article (Journal)
Sprache:Englisch
Veröffentlicht: 25 February 2018
In: Journal of cachexia, sarcopenia and muscle
Year: 2018, Jahrgang: 9, Heft: 3, Pages: 505-513
ISSN:2190-6009
DOI:10.1002/jcsm.12279
Online-Zugang:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1002/jcsm.12279
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Verfasserangaben: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
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Zusammenfassung: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.
Beschreibung:Gesehen am 24.03.2020
Beschreibung:Online Resource
ISSN:2190-6009
DOI:10.1002/jcsm.12279

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