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. 2023;76(2):81-89.
doi: 10.5173/ceju.2023.14. Epub 2023 May 5.

Sarcopenia is an independent predictor of survival in patients undergoing radical cystectomy for bladder cancer: a single-centre, retrospective study

Anil Erdik  1 , Haci Ibrahim Cimen  2 , Yavuz Tarik Atik  2 , Deniz Gul  2 , Osman Kose  2 , Fikret Halis  2 , Hasan Salih Saglam  2 , Omer Faruk Ates  3
Affiliations

Sarcopenia is an independent predictor of survival in patients undergoing radical cystectomy for bladder cancer: a single-centre, retrospective study

Anil Erdik et al. Cent European J Urol. 2023.

Abstract

Introduction: This study aimed to determine whether sarcopenia is a predictor of overall survival (OS) and cancer-specific survival (CSS) in patients with bladder cancer (BC) undergoing radical cystectomy (RC).

Material and methods: Patients who underwent radical cystectomy for BC between September 2016 and June 2022 were retrospectively reviewed. Patients underwent digital computed tomography (CT) scans of the abdomen and pelvis. The skeletal muscle index (SMI) was used to assess sarcopenia using CT images. OS and CSS were estimated using Kaplan-Meier curves. Predictors of CSS and OS were analysed using univariate and multivariate Cox regression models.

Results: Of the 84 reviewed patients, 45 (53.6%) had sarcopenia. The median follow-up period for survivors was 70 months. Patients with sarcopenia were older and had a lower BMI, but other preoperative clinical and laboratory parameters were similar to those of patients without sarcopenia. During follow-up, 57 (67.9%) patients died, 39 (46.4%) due to BC. In addition, patients with sarcopenia had worse 5-year OS (24.4% vs 41.0%, p = 0.036) and CSS (35.6% vs 61.5%, p = 0.012) than non-sarcopenic patients. The findings indicate that sarcopenia is an independent predictor of increased CSS (HR, 2.841; p = 0.003) and overall mortality (HR, 2.465; p = 0.004) in multivariate analysis.

Conclusions: The results of this study support the view that sarcopenia is an important risk factor for predicting CSS and OS in BC patients undergoing RC.

Keywords: bladder cancer; frailty; radical cystectomy; sarcopenia; survival.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Axial CT images at the third lumbar vertebra region with skeletal muscle highlighted in green. Figure A represents a male non-sarcopenic patient with a skeletal muscle index (SMI) of 58.1, and Figure B represents a sarcopenic male patient with an SMI of 38.7. The green regions represent the skeletal muscle, identified by attenuation limits of -29 to +110 Hounsfield units (HU). The SMI is calculated by dividing the cross-sectional skeletal muscle area (cm2) by the patient’s height squared (m2).
Figure 2
Figure 2
Kaplan-Meier curves depicting overall survival (left) and cancer-specific survival (right) are shown in patients with and without sarcopenia.
See this image and copyright information in PMC

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