TY - JOUR
T1 - Sarcopenia in patients with bladder cancer undergoing radical cystectomy
T2 - Impact on cancer-specific and all-cause mortality
AU - Psutka, Sarah P.
AU - Carrasco, Alonso
AU - Schmit, Grant D.
AU - Moynagh, Michael R.
AU - Boorjian, Stephen A.
AU - Frank, Igor
AU - Merrill, Suzanne
AU - Thapa, Prabin
AU - Tarrell, Robert F.
AU - Cheville, John C.
AU - Tollefson, Matthew K.
PY - 2014/9/1
Y1 - 2014/9/1
N2 - BACKGROUND: The authors evaluated sarcopenia as a predictor of cancer-specific survival (CSS) and overall survival (OS) among patients with urothelial cancer of the bladder undergoing radical cystectomy (RC). METHODS: The lumbar skeletal muscle index (SMI) of 205 patients treated with RC for urothelial cancer between 2000 and 2007 was measured. Sarcopenia was classified according to international consensus definitions (SMI of<55 cm2m2 for men and <39 cm2m2 for women). The CSS and OS were estimated using the Kaplan-Meier method and compared with the log-rank test. Variables associated with CSS and all-cause mortality were summarized with hazard ratios (HRs). RESULTS: Of 205 patients, 141 (68.8%) were sarcopenic. Patients with sarcopenia were older, but were otherwise similar to patients without sarcopenia with respect to sex, Charlson comorbidity index, American Society of Anesthesiologists score, Eastern Cooperative Oncology Group performance status, receipt of neoadjuvant chemotherapy, TNM stage of disease, and tumor grade (P.05 for all). The median follow-up was 6.7 years, during which time 135 patients died, including 91 who died of bladder cancer. Sarcopenic patients had significantly worse 5-year CSS (49% vs 72%; P5.003) and OS (39% vs 70%; P=.003) compared with patients without sarcopenia. Moreover, sarcopenia was found to be independently associated with both increased CSS (HR, 2.14; P=.007) and all-cause mortality (HR, 1.93; P=.004) on multivariable analysis. CONCLUSIONS: The presence of sarcopenia was found to significantly increase a patient's risk of CSS and all-cause mortality after undergoing RC for bladder cancer.
AB - BACKGROUND: The authors evaluated sarcopenia as a predictor of cancer-specific survival (CSS) and overall survival (OS) among patients with urothelial cancer of the bladder undergoing radical cystectomy (RC). METHODS: The lumbar skeletal muscle index (SMI) of 205 patients treated with RC for urothelial cancer between 2000 and 2007 was measured. Sarcopenia was classified according to international consensus definitions (SMI of<55 cm2m2 for men and <39 cm2m2 for women). The CSS and OS were estimated using the Kaplan-Meier method and compared with the log-rank test. Variables associated with CSS and all-cause mortality were summarized with hazard ratios (HRs). RESULTS: Of 205 patients, 141 (68.8%) were sarcopenic. Patients with sarcopenia were older, but were otherwise similar to patients without sarcopenia with respect to sex, Charlson comorbidity index, American Society of Anesthesiologists score, Eastern Cooperative Oncology Group performance status, receipt of neoadjuvant chemotherapy, TNM stage of disease, and tumor grade (P.05 for all). The median follow-up was 6.7 years, during which time 135 patients died, including 91 who died of bladder cancer. Sarcopenic patients had significantly worse 5-year CSS (49% vs 72%; P5.003) and OS (39% vs 70%; P=.003) compared with patients without sarcopenia. Moreover, sarcopenia was found to be independently associated with both increased CSS (HR, 2.14; P=.007) and all-cause mortality (HR, 1.93; P=.004) on multivariable analysis. CONCLUSIONS: The presence of sarcopenia was found to significantly increase a patient's risk of CSS and all-cause mortality after undergoing RC for bladder cancer.
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U2 - 10.1002/cncr.28798
DO - 10.1002/cncr.28798
M3 - Article
C2 - 24840856
AN - SCOPUS:84908028657
SN - 0008-543X
VL - 120
SP - 2910
EP - 2918
JO - Cancer
JF - Cancer
IS - 18
ER -
