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Review
. 2018 Oct 1;19(10):2999.
doi: 10.3390/ijms19102999.

Impact of Sarcopenia as a Prognostic Biomarker of Bladder Cancer

Hiroshi Fukushima  1 , Kosuke Takemura  2 , Hiroaki Suzuki  3 , Fumitaka Koga  4
Affiliations
Review

Impact of Sarcopenia as a Prognostic Biomarker of Bladder Cancer

Hiroshi Fukushima et al. Int J Mol Sci. .

Abstract

Sarcopenia, the degenerative and systemic loss of skeletal muscle mass, indicates patient frailty and impaired physical function. Sarcopenia can be caused by multiple factors, including advanced age, lack of exercise, poor nutritional status, inflammatory diseases, endocrine diseases, and malignancies. In patients with cancer cachexia, anorexia, poor nutrition and systemic inflammation make the metabolic state more catabolic, resulting in sarcopenia. Thus, sarcopenia is considered as one of manifestations of cancer cachexia. Recently, growing evidence has indicated the importance of sarcopenia in the management of patients with various cancers. Sarcopenia is associated with not only higher rates of treatment-related complications but also worse prognosis in cancer-bearing patients. In this article, we summarized metabolic backgrounds of cancer cachexia and sarcopenia and definitions of sarcopenia based on computed tomography (CT) images. We conducted a systematic literature review regarding the significance of sarcopenia as a prognostic biomarker of bladder cancer. We also reviewed recent studies focusing on the prognostic role of changes in skeletal muscle mass during the course of treatment in bladder cancer patients. Lastly, we discussed the impact of nutritional support, medication, and exercise on sarcopenia in cancer-bearing patients.

Keywords: biomarker; bladder cancer; prognosis; sarcopenia; urothelial carcinoma.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Computed tomography (CT) images of typical sarcopenic and non-sarcopenic cases. Skeletal muscle area is shown in red.
Figure 2
Figure 2
Hybrid nature of sarcopenia.
Figure 3
Figure 3
Flow diagram of systematic literature search.
See this image and copyright information in PMC

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