Impact of preoperative sarcopenia and myosteatosis on prognosis after radical cystectomy in patients with bladder cancer

• Published in: International journal of urology 2021-07, Vol.28 (7), p.757-762
• Main Authors: Yamashita, Shimpei, Iguchi, Takashi, Koike, Hiroyuki, Wakamiya, Takahito, Kikkawa, Kazuro, Kohjimoto, Yasuo, Hara, Isao
• Format: Article
• Language: English
• Subjects: Bladder cancer; body composition; Cancer; Computed tomography; cystectomy; Medical prognosis; Musculoskeletal system; prognosis; Risk factors; Sarcopenia; Skeletal muscle; Survival; urinary bladder neoplasms
• ISSN: 0919-8172; 1442-2042
• DOI: 10.1111/iju.14569

Objective To evaluate the prognostic impact of sarcopenia and myosteatosis on survival after radical cystectomy for bladder cancer. Methods We retrospectively reviewed consecutive patients who underwent radical cystectomy for bladder cancer between 2010 and 2019, and 123 patients were finally included in this single‐center study. Pretreatment computed tomography images at the L3 level were used to calculate skeletal muscle index and skeletal muscle density. Sarcopenia and myosteatosis were diagnosed according to the gender‐specific cutoff values of skeletal muscle index and skeletal muscle density used in a previous study. We compared overall survival and cancer‐specific survival between patients with and without sarcopenia/myosteatosis. We also performed Cox proportional regression analyses to identify the predictors of overall survival and cancer‐specific survival. Results The median patient age was 74 years, and 20 patients (16%) were female. Thirty‐eight patients (31%) died from bladder cancer and 13 (11%) died from other causes. The patients with sarcopenia (n = 48, 39%) and those with myosteatosis (n = 101, 82%) had significantly lower overall survival and cancer‐specific survival rates than those without sarcopenia and those without myosteatosis, respectively. In multivariable analysis, in addition to the number of pathological risk factors, both sarcopenia (P