Mayr, Roman and Gierth, Michael and Zeman, Florian and Reiffen, Marieke and Seeger, Philipp and Wezel, Felix and Pycha, Armin and Comploj, Evi and Bonatti, Matteo and Ritter, Manuel and van Rhijn, Bas W. G. and Burger, Maximilian and Bolenz, Christian and Fritsche, Hans-Martin and Martini, Thomas (2018) Sarcopenia as a comorbidity-independent predictor of survival following radical cystectomy for bladder cancer. JOURNAL OF CACHEXIA SARCOPENIA AND MUSCLE, 9 (3). pp. 505-513. ISSN 2190-5991, 2190-6009
Full text not available from this repository. (Request a copy)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.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | SKELETAL-MUSCLE INDEX; PROGNOSTIC-FACTOR; COMPLICATIONS; PERFORMANCE; MANAGEMENT; MORTALITY; CACHEXIA; AGE; Frailty; Skeletal muscle mass; Bladder cancer; Prognosis; Urinary bladder neoplasm |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Urologie |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 09 Mar 2020 08:34 |
| Last Modified: | 09 Mar 2020 08:34 |
| URI: | https://pred.uni-regensburg.de/id/eprint/14438 |
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