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Sarcopenia as a comorbidity‐independent predictor of survival following radical cystectomy for bladder cancer

BACKGROUND: A multicentre study was conducted to investigate the impact of sarcopenia as an independent predictor of oncological outcome after radical cystectomy for bladder cancer. METHODS: In total, 500 patients with available digital computed tomography scans of the abdomen obtained within 90 day...

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Autores principales: Mayr, Roman, Gierth, Michael, Zeman, Florian, Reiffen, Marieke, Seeger, Philipp, Wezel, Felix, Pycha, Armin, Comploj, Evi, Bonatti, Matteo, Ritter, Manuel, van Rhijn, Bas W.G., Burger, Maximilian, Bolenz, Christian, Fritsche, Hans‐Martin, Martini, Thomas
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5989852/
https://www.ncbi.nlm.nih.gov/pubmed/29479839
http://dx.doi.org/10.1002/jcsm.12279
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author Mayr, Roman
Gierth, Michael
Zeman, Florian
Reiffen, Marieke
Seeger, Philipp
Wezel, Felix
Pycha, Armin
Comploj, Evi
Bonatti, Matteo
Ritter, Manuel
van Rhijn, Bas W.G.
Burger, Maximilian
Bolenz, Christian
Fritsche, Hans‐Martin
Martini, Thomas
author_facet Mayr, Roman
Gierth, Michael
Zeman, Florian
Reiffen, Marieke
Seeger, Philipp
Wezel, Felix
Pycha, Armin
Comploj, Evi
Bonatti, Matteo
Ritter, Manuel
van Rhijn, Bas W.G.
Burger, Maximilian
Bolenz, Christian
Fritsche, Hans‐Martin
Martini, Thomas
author_sort Mayr, Roman
collection PubMed
description BACKGROUND: A multicentre study was conducted to investigate the impact of sarcopenia as an independent predictor of oncological outcome after radical cystectomy for bladder cancer. METHODS: In total, 500 patients with available digital computed tomography scans of the abdomen obtained within 90 days before surgery were identified. The lumbar skeletal muscle index was measured using pre‐operative computed tomography. Cancer‐specific survival (CSS) and overall survival (OS) were estimated using Kaplan–Meier curves. Predictors of CSS and OS were analysed by univariable and multivariable Cox regression models. RESULTS: Based on skeletal muscle index, 189 patients (37.8%) were classified as sarcopenic. Patients with sarcopenia were older compared with their counterparts (P = 0.002), but both groups were comparable regarding to gender, comorbidity, tumor, node, metastasis (TNM) stage, and type of urinary diversion (all P > 0.05). In total, 234 (46.8%) patients died, and of these, 145 (29.0%) died because of urothelial carcinoma of the bladder. Sarcopenic patients had significantly worse 5 year OS (38.3% vs. 50.5%; P = 0.002) and 5 year CSS (49.5% vs. 62.3%; P = 0.016) rates compared with patients without sarcopenia. Moreover, sarcopenia was associated independently with both increased all‐cause mortality (hazard ratio, 1.43; 95% confidence interval 1.09–1.87; P = 0.01) and increased cancer‐specific mortality (hazard ratio, 1.42; 95% confidence interval, 1.00–2.02; P = 0.048). Our results are limited by the lack of prospective frailty assessment. CONCLUSIONS: Sarcopenia has been shown to be an independent predictor for OS and CSS in a large multicentre study with patients undergoing radical cystectomy for bladder cancer.
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spelling pubmed-59898522018-06-20 Sarcopenia as a comorbidity‐independent predictor of survival following radical cystectomy for bladder cancer Mayr, Roman Gierth, Michael Zeman, Florian Reiffen, Marieke Seeger, Philipp Wezel, Felix Pycha, Armin Comploj, Evi Bonatti, Matteo Ritter, Manuel van Rhijn, Bas W.G. Burger, Maximilian Bolenz, Christian Fritsche, Hans‐Martin Martini, Thomas J Cachexia Sarcopenia Muscle Original Articles BACKGROUND: A multicentre study was conducted to investigate the impact of sarcopenia as an independent predictor of oncological outcome after radical cystectomy for bladder cancer. METHODS: In total, 500 patients with available digital computed tomography scans of the abdomen obtained within 90 days before surgery were identified. The lumbar skeletal muscle index was measured using pre‐operative computed tomography. Cancer‐specific survival (CSS) and overall survival (OS) were estimated using Kaplan–Meier curves. Predictors of CSS and OS were analysed by univariable and multivariable Cox regression models. RESULTS: Based on skeletal muscle index, 189 patients (37.8%) were classified as sarcopenic. Patients with sarcopenia were older compared with their counterparts (P = 0.002), but both groups were comparable regarding to gender, comorbidity, tumor, node, metastasis (TNM) stage, and type of urinary diversion (all P > 0.05). In total, 234 (46.8%) patients died, and of these, 145 (29.0%) died because of urothelial carcinoma of the bladder. Sarcopenic patients had significantly worse 5 year OS (38.3% vs. 50.5%; P = 0.002) and 5 year CSS (49.5% vs. 62.3%; P = 0.016) rates compared with patients without sarcopenia. Moreover, sarcopenia was associated independently with both increased all‐cause mortality (hazard ratio, 1.43; 95% confidence interval 1.09–1.87; P = 0.01) and increased cancer‐specific mortality (hazard ratio, 1.42; 95% confidence interval, 1.00–2.02; P = 0.048). Our results are limited by the lack of prospective frailty assessment. CONCLUSIONS: Sarcopenia has been shown to be an independent predictor for OS and CSS in a large multicentre study with patients undergoing radical cystectomy for bladder cancer. John Wiley and Sons Inc. 2018-02-25 2018-06 /pmc/articles/PMC5989852/ /pubmed/29479839 http://dx.doi.org/10.1002/jcsm.12279 Text en © 2018 The Authors. Journal of Cachexia, Sarcopenia and Muscle published by John Wiley & Sons Ltd on behalf of the Society on Sarcopenia, Cachexia and Wasting Disorders This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
spellingShingle Original Articles
Mayr, Roman
Gierth, Michael
Zeman, Florian
Reiffen, Marieke
Seeger, Philipp
Wezel, Felix
Pycha, Armin
Comploj, Evi
Bonatti, Matteo
Ritter, Manuel
van Rhijn, Bas W.G.
Burger, Maximilian
Bolenz, Christian
Fritsche, Hans‐Martin
Martini, Thomas
Sarcopenia as a comorbidity‐independent predictor of survival following radical cystectomy for bladder cancer
title Sarcopenia as a comorbidity‐independent predictor of survival following radical cystectomy for bladder cancer
title_full Sarcopenia as a comorbidity‐independent predictor of survival following radical cystectomy for bladder cancer
title_fullStr Sarcopenia as a comorbidity‐independent predictor of survival following radical cystectomy for bladder cancer
title_full_unstemmed Sarcopenia as a comorbidity‐independent predictor of survival following radical cystectomy for bladder cancer
title_short Sarcopenia as a comorbidity‐independent predictor of survival following radical cystectomy for bladder cancer
title_sort sarcopenia as a comorbidity‐independent predictor of survival following radical cystectomy for bladder cancer
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5989852/
https://www.ncbi.nlm.nih.gov/pubmed/29479839
http://dx.doi.org/10.1002/jcsm.12279
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