Abstract
BackgroundRecently, sarcopenia has been reported as a new predictor for patient outcomes or likelihood of post-operative complications. The purpose of this study was to evaluate the association of the psoas muscle volume with the length of hospitalization among patients undergoing radical cystectomy.MethodsA total of 63 (80.8%) male patients and 15 (19.2%) female patients who underwent radical cystectomy for their bladder cancer in our institution from 2000 to 2015 were analyzed. The psoas muscle index (PMI) was calculated by normalizing the psoas muscle area calculated using axial computed tomography at the level of the umbilicus (cm2) by the square of the body height (m2). Longer hospitalization was defined as hospitalization exceeding 30 days after surgery.ResultsThe median PMIs (mean ± standard deviation) were 391 (394 ± 92.1) and 271 (278 ± 92.6) cm2/m2 in men and women, respectively. Thus, the PMIs of male patients were significantly larger than those of females (p < 0.001). Based on the differences in gender, we analyzed 63 male patients for a further analysis. In male patients, those hospitalized longer showed a significantly smaller PMI than those normally discharged (377 ± 93.1 vs. 425 ± 83.4; p = 0.04). Similarly, male patients with a small PMI (<400) had a significantly worse overall survival (p = 0.02) than those with a large PMI (≥400).ConclusionsThe presence of sarcopenia was found to be associated with significantly longer hospitalization after radical cystectomy in male patients. Furthermore, in men, a PMI <400 may suggest a significantly worse prognosis.
Highlights
Sarcopenia has been reported as a new predictor for patient outcomes or likelihood of post-operative complications
Previous studies have defined the sum of the muscle masses of the four limbs as the appendicular skeletal mass in order to calculate the psoas muscle index (PMI) [9, 10]
A correlation between sarcopenia and oncologic outcomes has been reported in malignant melanoma, breast cancer, and hepatocellular carcinoma
Summary
Sarcopenia has been reported as a new predictor for patient outcomes or likelihood of post-operative complications. The purpose of this study was to evaluate the association of the psoas muscle volume with the length of hospitalization among patients undergoing radical cystectomy. Despite its effectiveness, the perioperative complication rate is reported to be around 30%, and the 30- and 90-day post-operative mortality rates are 3.2% and 5.2%, Sarcopenia is the age-related loss of skeletal muscle mass [8]. A correlation between sarcopenia and oncologic outcomes has been reported in malignant melanoma, breast cancer, and hepatocellular carcinoma. Whether or not the PMI determined using the one-side psoas volume in non-contrast computed tomography (CT) precisely predicts post-operative complications as well as the long-term oncologic outcomes in patients undergoing radical cystectomy remains controversial
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