Decrease in skeletal muscle index one year after radical cystectomy as a prognostic indicator in patients with urothelial bladder cancer

Abstract

Purpose The present study aimed to determine whether sarcopenia after radical cystectomy (RC) could predict overall survival (OS) in patients with urothelial bladder cancer (UBC).Materials and Methods The lumbar skeletal muscle index (SMI) of 80 patients was measured before and 1 year after RC. The prognostic significance of sarcopenia and SMI decrease after RC were evaluated using Kaplan–Meier analysis and a multivariable Cox regression model.Results Of 80 patients, 26 (32.5%) experienced sarcopenia before RC, whereas 40 (50.0%) experienced sarcopenia after RC. The median SMI change was -2.2 cm2/m2. Patients with sarcopenia after RC had a higher pathological T stage and tumor grade than patients without sarcopenia. Furthermore, the overall mortality rate was significantly higher in patients with sarcopenia than in those without sarcopenia 1 year after RC. The median follow-up time was 46.2 months, during which 22 patients died. Kaplan-Meier estimates showed a significant difference in OS rates based on sarcopenia (P=0.012) and SMI decrease (P=0.025). Multivariable Cox regression analysis showed that SMI decrease (≥2.2 cm2/m2) was an independent predictor of OS (hazard ratio: 2.68, confidence interval: 1.007-7.719, P = 0.048).Conclusions The decrease in SMI after surgery might be a negative prognostic factor for OS in patients who underwent RC to treat UBC.

Impact of sarcopenia on outcomes of bladder cancer undergoing radical cystectomy: A systematic review and meta-analysis

“…Ultimately, our meta-analysis comprised 21 studies, as depicted in Figure 1. 20–40 Specific details of the included studies are presented in Table 1. The majority of studies (n = 19) had a retrospective design, while two studies had a prospective design.…”

Impact of Sarcopenia on Functional and Oncological Outcomes After Radical Prostatectomy

“…The change in SMI is not considered. Ha et al showed a significant change in sarcopenia and SMI 1 year after radical cystectomy and might be an effective marker for oncological outcome ( 31 ). Another limitation of this study is the time of follow-up after RP, which limits the statement of sarcopenia effecting BCR.…”

Predictive role of pretreatment skeletal muscle mass index for long-term survival of bladder cancer patients: A meta-analysis

“…A total of 126 records were identified from databases and 27 duplicated records were removed. Eventually, nine studies were included [19][20][21][22][23][24][25][26][27]. The detailed selection process was shown in the Fig 1.…”

“…Among nine retrospective included studies, 1476 patients were enrolled and the sample size ranged from 80 to 500 [19][20][21][22][23][24][25][26][27]. Among four of included studies the cutoff values of SMI, 55cm 2 /m 2 for male and 39cm 2 /m 2 for female, were applied [19,21,24,27].…”