Sarcopenia in patients with bladder cancer undergoing radical cystectomy

Impact on cancer-specific and all-cause mortality

Sarah P. Psutka, Alonso Carrasco, Grant D. Schmit, Michael R. Moynagh, Stephen A. Boorjian, Igor Frank, Suzanne B. Stewart, Prabin Thapa, Robert F. Tarrell, John C. Cheville, Matthew K. Tollefson

Research output: Contribution to journalArticle

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Abstract

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.

Original languageEnglish (US)
Pages (from-to)2910-2918
Number of pages9
JournalCancer
Volume120
Issue number18
DOIs
StatePublished - Sep 1 2014

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Sarcopenia
Cystectomy
Urinary Bladder Neoplasms
Survival
Mortality
Neoplasms
Skeletal Muscle
Comorbidity
Drug Therapy

Keywords

  • Bladder cancer
  • Frailty
  • Mortality
  • Radical cystectomy
  • Sarcopenia
  • Survival

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Psutka, S. P., Carrasco, A., Schmit, G. D., Moynagh, M. R., Boorjian, S. A., Frank, I., ... Tollefson, M. K. (2014). Sarcopenia in patients with bladder cancer undergoing radical cystectomy: Impact on cancer-specific and all-cause mortality. Cancer, 120(18), 2910-2918. https://doi.org/10.1002/cncr.28798

Sarcopenia in patients with bladder cancer undergoing radical cystectomy : Impact on cancer-specific and all-cause mortality. / Psutka, Sarah P.; Carrasco, Alonso; Schmit, Grant D.; Moynagh, Michael R.; Boorjian, Stephen A.; Frank, Igor; Stewart, Suzanne B.; Thapa, Prabin; Tarrell, Robert F.; Cheville, John C.; Tollefson, Matthew K.

In: Cancer, Vol. 120, No. 18, 01.09.2014, p. 2910-2918.

Research output: Contribution to journalArticle

Psutka, SP, Carrasco, A, Schmit, GD, Moynagh, MR, Boorjian, SA, Frank, I, Stewart, SB, Thapa, P, Tarrell, RF, Cheville, JC & Tollefson, MK 2014, 'Sarcopenia in patients with bladder cancer undergoing radical cystectomy: Impact on cancer-specific and all-cause mortality', Cancer, vol. 120, no. 18, pp. 2910-2918. https://doi.org/10.1002/cncr.28798
Psutka, Sarah P. ; Carrasco, Alonso ; Schmit, Grant D. ; Moynagh, Michael R. ; Boorjian, Stephen A. ; Frank, Igor ; Stewart, Suzanne B. ; Thapa, Prabin ; Tarrell, Robert F. ; Cheville, John C. ; Tollefson, Matthew K. / Sarcopenia in patients with bladder cancer undergoing radical cystectomy : Impact on cancer-specific and all-cause mortality. In: Cancer. 2014 ; Vol. 120, No. 18. pp. 2910-2918.
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title = "Sarcopenia in patients with bladder cancer undergoing radical cystectomy: Impact on cancer-specific and all-cause mortality",
abstract = "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.",
keywords = "Bladder cancer, Frailty, Mortality, Radical cystectomy, Sarcopenia, Survival",
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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 - Stewart, Suzanne B.

AU - Thapa, Prabin

AU - Tarrell, Robert F.

AU - Cheville, John C.

AU - Tollefson, Matthew K.

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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.

KW - Bladder cancer

KW - Frailty

KW - Mortality

KW - Radical cystectomy

KW - Sarcopenia

KW - Survival

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