The Association Between Sarcopenia and Oncologic Outcomes After Radical Prostatectomy

Ross J. Mason, Stephen A. Boorjian, Bimal Bhindi, Laureano Rangel, Igor Frank, Robert Jeffrey Karnes, Matthew K. Tollefson

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Purpose: Sarcopenia is associated with inferior perioperative and oncologic outcomes in patients undergoing surgery for multiple malignancies. The purpose of this study was to evaluate the association between sarcopenia and outcomes after radical prostatectomy (RP) for men with prostate cancer. Patients and Methods: Using a representative computed tomographic image from the L3 level, preoperative skeletal muscle indices (SMI) calculated for 698 patients who underwent RP between 2007 and 2010. Patients were classified as sarcopenic if they had a SMI < 55 cm2/kg2 according to international consensus. The associations between sarcopenia and biochemical recurrence (BCR), systemic progression (SP), and all-cause mortality (ACM) were investigated by Cox proportional hazards regression. Results: Sarcopenic patients were older than nonsarcopenic patients (mean age, 63.0 vs. 60.4 years, P < .001) but were otherwise similar with regard to clinical and pathologic characteristics. There was no significant difference in the perioperative complication rate after RP between sarcopenic and nonsarcopenic patients (16.5% vs. 17.4%, P = .82). At a median follow-up after surgery of 6.0 years, 152 patients were diagnosed with BCR, patients were diagnosed with SP, and 50 patients died. In multivariable analysis, the presence of sarcopenia was not significantly associated with the risks of BCR, SP, or ACM. Similar results were obtained when analyzing SMI as a continuous variable. Conclusion: Sarcopenia was not found to be independently associated with perioperative complications or oncologic outcomes after RP. As such, the presence of sarcopenia may not be prognostic marker for inferior outcomes among men with localized prostate cancer undergoing RP.

Original languageEnglish (US)
JournalClinical Genitourinary Cancer
DOIs
StateAccepted/In press - Jan 1 2018

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Sarcopenia
Prostatectomy
Skeletal Muscle
Recurrence
Prostatic Neoplasms
Mortality

Keywords

  • Biochemical recurrence
  • Body composition
  • Prostate cancer
  • Skeletal muscle mass
  • Survival

ASJC Scopus subject areas

  • Oncology
  • Urology

Cite this

The Association Between Sarcopenia and Oncologic Outcomes After Radical Prostatectomy. / Mason, Ross J.; Boorjian, Stephen A.; Bhindi, Bimal; Rangel, Laureano; Frank, Igor; Karnes, Robert Jeffrey; Tollefson, Matthew K.

In: Clinical Genitourinary Cancer, 01.01.2018.

Research output: Contribution to journalArticle

Mason, Ross J. ; Boorjian, Stephen A. ; Bhindi, Bimal ; Rangel, Laureano ; Frank, Igor ; Karnes, Robert Jeffrey ; Tollefson, Matthew K. / The Association Between Sarcopenia and Oncologic Outcomes After Radical Prostatectomy. In: Clinical Genitourinary Cancer. 2018.
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abstract = "Purpose: Sarcopenia is associated with inferior perioperative and oncologic outcomes in patients undergoing surgery for multiple malignancies. The purpose of this study was to evaluate the association between sarcopenia and outcomes after radical prostatectomy (RP) for men with prostate cancer. Patients and Methods: Using a representative computed tomographic image from the L3 level, preoperative skeletal muscle indices (SMI) calculated for 698 patients who underwent RP between 2007 and 2010. Patients were classified as sarcopenic if they had a SMI < 55 cm2/kg2 according to international consensus. The associations between sarcopenia and biochemical recurrence (BCR), systemic progression (SP), and all-cause mortality (ACM) were investigated by Cox proportional hazards regression. Results: Sarcopenic patients were older than nonsarcopenic patients (mean age, 63.0 vs. 60.4 years, P < .001) but were otherwise similar with regard to clinical and pathologic characteristics. There was no significant difference in the perioperative complication rate after RP between sarcopenic and nonsarcopenic patients (16.5{\%} vs. 17.4{\%}, P = .82). At a median follow-up after surgery of 6.0 years, 152 patients were diagnosed with BCR, patients were diagnosed with SP, and 50 patients died. In multivariable analysis, the presence of sarcopenia was not significantly associated with the risks of BCR, SP, or ACM. Similar results were obtained when analyzing SMI as a continuous variable. Conclusion: Sarcopenia was not found to be independently associated with perioperative complications or oncologic outcomes after RP. As such, the presence of sarcopenia may not be prognostic marker for inferior outcomes among men with localized prostate cancer undergoing RP.",
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AU - Frank, Igor

AU - Karnes, Robert Jeffrey

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N2 - Purpose: Sarcopenia is associated with inferior perioperative and oncologic outcomes in patients undergoing surgery for multiple malignancies. The purpose of this study was to evaluate the association between sarcopenia and outcomes after radical prostatectomy (RP) for men with prostate cancer. Patients and Methods: Using a representative computed tomographic image from the L3 level, preoperative skeletal muscle indices (SMI) calculated for 698 patients who underwent RP between 2007 and 2010. Patients were classified as sarcopenic if they had a SMI < 55 cm2/kg2 according to international consensus. The associations between sarcopenia and biochemical recurrence (BCR), systemic progression (SP), and all-cause mortality (ACM) were investigated by Cox proportional hazards regression. Results: Sarcopenic patients were older than nonsarcopenic patients (mean age, 63.0 vs. 60.4 years, P < .001) but were otherwise similar with regard to clinical and pathologic characteristics. There was no significant difference in the perioperative complication rate after RP between sarcopenic and nonsarcopenic patients (16.5% vs. 17.4%, P = .82). At a median follow-up after surgery of 6.0 years, 152 patients were diagnosed with BCR, patients were diagnosed with SP, and 50 patients died. In multivariable analysis, the presence of sarcopenia was not significantly associated with the risks of BCR, SP, or ACM. Similar results were obtained when analyzing SMI as a continuous variable. Conclusion: Sarcopenia was not found to be independently associated with perioperative complications or oncologic outcomes after RP. As such, the presence of sarcopenia may not be prognostic marker for inferior outcomes among men with localized prostate cancer undergoing RP.

AB - Purpose: Sarcopenia is associated with inferior perioperative and oncologic outcomes in patients undergoing surgery for multiple malignancies. The purpose of this study was to evaluate the association between sarcopenia and outcomes after radical prostatectomy (RP) for men with prostate cancer. Patients and Methods: Using a representative computed tomographic image from the L3 level, preoperative skeletal muscle indices (SMI) calculated for 698 patients who underwent RP between 2007 and 2010. Patients were classified as sarcopenic if they had a SMI < 55 cm2/kg2 according to international consensus. The associations between sarcopenia and biochemical recurrence (BCR), systemic progression (SP), and all-cause mortality (ACM) were investigated by Cox proportional hazards regression. Results: Sarcopenic patients were older than nonsarcopenic patients (mean age, 63.0 vs. 60.4 years, P < .001) but were otherwise similar with regard to clinical and pathologic characteristics. There was no significant difference in the perioperative complication rate after RP between sarcopenic and nonsarcopenic patients (16.5% vs. 17.4%, P = .82). At a median follow-up after surgery of 6.0 years, 152 patients were diagnosed with BCR, patients were diagnosed with SP, and 50 patients died. In multivariable analysis, the presence of sarcopenia was not significantly associated with the risks of BCR, SP, or ACM. Similar results were obtained when analyzing SMI as a continuous variable. Conclusion: Sarcopenia was not found to be independently associated with perioperative complications or oncologic outcomes after RP. As such, the presence of sarcopenia may not be prognostic marker for inferior outcomes among men with localized prostate cancer undergoing RP.

KW - Biochemical recurrence

KW - Body composition

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KW - Skeletal muscle mass

KW - Survival

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