Sarcopenia as a comorbidity-independent predictor of survival following radical cystectomy for bladder cancer

• Verfasst von: Mayr, Roman [VerfasserIn]
• Verfasst von: Gierth, Michael [VerfasserIn]
• Verfasst von: Zeman, Florian [VerfasserIn]
• Verfasst von: Reiffen, Marieke [VerfasserIn]
• Verfasst von: Seeger, Philipp [VerfasserIn]
• Verfasst von: Wezel, Felix [VerfasserIn]
• Verfasst von: Pycha, Armin [VerfasserIn]
• Verfasst von: Comploj, Evi [VerfasserIn]
• Verfasst von: Bonatti, Matteo [VerfasserIn]
• Verfasst von: Ritter, Manuel [VerfasserIn]
• Verfasst von: van Rhijn, Bas W. G. [VerfasserIn]
• Verfasst von: Burger, Maximilian [VerfasserIn]
• Verfasst von: Bolenz, Christian [VerfasserIn]
• Verfasst von: Fritsche, Hans-Martin [VerfasserIn]
• Verfasst von: Martini, Thomas [VerfasserIn]
• Titel: Sarcopenia as a comorbidity-independent predictor of survival following radical cystectomy for bladder cancer
• Verf.angabe: 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
• E-Jahr: 2018
• Jahr: 25 February 2018
• Umfang: 9 S.
• Fussnoten: Gesehen am 24.03.2020
• Titel Quelle: Enthalten in: Journal of cachexia, sarcopenia and muscle
• Ort Quelle: Hoboken, NJ : Wiley, 2010
• Jahr Quelle: 2018
• Band/Heft Quelle: 9(2018), 3, Seite 505-513
• ISSN Quelle: 2190-6009
• DOI: doi:10.1002/jcsm.12279
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: Aged
• Sach-SW: Aged, 80 and over
• Sach-SW: Biomarkers
• Sach-SW: Bladder cancer
• Sach-SW: Body Composition
• Sach-SW: Comorbidity
• Sach-SW: Cystectomy
• Sach-SW: Female
• Sach-SW: Frailty
• Sach-SW: Humans
• Sach-SW: Kaplan-Meier Estimate
• Sach-SW: Male
• Sach-SW: Muscle, Skeletal
• Sach-SW: Postoperative Period
• Sach-SW: Prognosis
• Sach-SW: Proportional Hazards Models
• Sach-SW: Sarcopenia
• Sach-SW: Skeletal muscle mass
• Sach-SW: Tomography, X-Ray Computed
• Sach-SW: Urinary bladder neoplasm
• Sach-SW: Urinary Bladder Neoplasms
• K10plus-PPN: 1693175800

Abstract

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.