TY - JOUR
T1 - The Association Between Sarcopenia and Oncologic Outcomes After Radical Prostatectomy
AU - Mason, Ross J.
AU - Boorjian, Stephen A.
AU - Bhindi, Bimal
AU - Rangel, Laureano
AU - Frank, Igor
AU - Karnes, R. Jeffrey
AU - Tollefson, Matthew K.
N1 - Publisher Copyright:
© 2017 Elsevier Inc.
PY - 2018/6
Y1 - 2018/6
N2 - In a study of the association between sarcopenia and outcomes after radical prostatectomy (RP) for men with prostate cancer, skeletal muscle mass was not found to be predictive of complications, biochemical recurrence, or survival after RP. The presence of sarcopenia should not be used to risk stratify men undergoing RP. 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 - In a study of the association between sarcopenia and outcomes after radical prostatectomy (RP) for men with prostate cancer, skeletal muscle mass was not found to be predictive of complications, biochemical recurrence, or survival after RP. The presence of sarcopenia should not be used to risk stratify men undergoing RP. 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
KW - Prostate cancer
KW - Skeletal muscle mass
KW - Survival
UR - http://www.scopus.com/inward/record.url?scp=85042283799&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85042283799&partnerID=8YFLogxK
U2 - 10.1016/j.clgc.2017.11.003
DO - 10.1016/j.clgc.2017.11.003
M3 - Article
C2 - 29289518
AN - SCOPUS:85042283799
SN - 1558-7673
VL - 16
SP - e629-e636
JO - Clinical Genitourinary Cancer
JF - Clinical Genitourinary Cancer
IS - 3
ER -