Impact of Sarcopenia as a Prognostic Biomarker of Bladder Cancer

Abstract

Sarcopenia, the degenerative and systemic loss of skeletal muscle mass, indicates patient frailty and impaired physical function. Sarcopenia can be caused by multiple factors, including advanced age, lack of exercise, poor nutritional status, inflammatory diseases, endocrine diseases, and malignancies. In patients with cancer cachexia, anorexia, poor nutrition and systemic inflammation make the metabolic state more catabolic, resulting in sarcopenia. Thus, sarcopenia is considered as one of manifestations of cancer cachexia. Recently, growing evidence has indicated the importance of sarcopenia in the management of patients with various cancers. Sarcopenia is associated with not only higher rates of treatment-related complications but also worse prognosis in cancer-bearing patients. In this article, we summarized metabolic backgrounds of cancer cachexia and sarcopenia and definitions of sarcopenia based on computed tomography (CT) images. We conducted a systematic literature review regarding the significance of sarcopenia as a prognostic biomarker of bladder cancer. We also reviewed recent studies focusing on the prognostic role of changes in skeletal muscle mass during the course of treatment in bladder cancer patients. Lastly, we discussed the impact of nutritional support, medication, and exercise on sarcopenia in cancer-bearing patients.

Sarcopenia as an independent predictor of the surgical outcomes of patients with inflammatory bowel disease: a meta-analysis

“…Sarcopenia in the elderly is often related to adverse health outcomes including a higher risk of hospitalization and mortality with associated increased healthcare costs [7,8]. Recently, sarcopenia was implicated as a prognostic factor in a wide range of diseases, such as cancer [9,10], chronic liver diseases [11], chronic pancreatitis [12], rheumatic diseases [13] and inflammatory bowel disease (IBD) [14].…”

Metabolic and Molecular Basis of Sarcopenia: Implications in the Management of Urothelial Carcinoma

“…Moreover, sarcopenia can contribute to higher rates of treatment-related complications in various cancers, including those due to surgical treatment, chemotherapy, or tyrosine kinase inhibitors [25,26,27]. As for urothelial carcinoma, many studies reported that sarcopenia was significantly associated with higher rates of treatment-related complications and worse prognosis [28]. Sarcopenia was a significant predictor for higher rates of perioperative complications and worse cancer-specific survival after radical cystectomy [29,30].…”

A low psoas muscle volume is associated with a poor prognosis in penile cancer

“…Second, we were unable to reveal the mechanism underlying the relationship between a low PMI and a poor prognosis in penile cancer. A low PMI has been thought to reflect anemia, a low BMI, inadequate nutrition, and the effects of other diseases [22]. Thought this findings, the molecular mechanism has yet to be clarified.…”