MP41-06 THE ROLE OF MALNUTRITION UNIVERSAL SCREENING TOOL IN PREDICTING OUTCOMES AFTER RADICAL CYSTECTOMY

Abstract

You have accessJournal of UrologyBladder Cancer: Invasive II (MP41)1 Sep 2021MP41-06 THE ROLE OF MALNUTRITION UNIVERSAL SCREENING TOOL IN PREDICTING OUTCOMES AFTER RADICAL CYSTECTOMY Ziv Savin, Aviv Kupershmidt, Snir Dekalo, Dorel Poulin, Ofer Yossepowitch, Alon Lazarovich, Barak Rosenzwieg, Reut Shashar, Azik Hoffman, Jonathan Gal, Miki Haifler, and Roy Mano Ziv SavinZiv Savin More articles by this author , Aviv KupershmidtAviv Kupershmidt More articles by this author , Snir DekaloSnir Dekalo More articles by this author , Dorel PoulinDorel Poulin More articles by this author , Ofer YossepowitchOfer Yossepowitch More articles by this author , Alon LazarovichAlon Lazarovich More articles by this author , Barak RosenzwiegBarak Rosenzwieg More articles by this author , Reut ShasharReut Shashar More articles by this author , Azik HoffmanAzik Hoffman More articles by this author , Jonathan GalJonathan Gal More articles by this author , Miki HaiflerMiki Haifler More articles by this author , and Roy ManoRoy Mano More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002062.06AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The Malnutrition Universal Screening Tool (MUST) integrates body mass index and unplanned weight loss to assess the nutritional status of patients, and was previously associated with adverse outcomes after gastrointestinal operations. The predictive role of MUST among patients undergoing radical cystectomy is unknown. METHODS: We conducted a multi-center retrospective analysis of 227 patients who underwent radical cystectomy for bladder cancer in 4 medical centers between 2015-2019. Patients were stratified according to the MUST score [MUST=0 (n=188) vs. MUST ≥1 (n=39)]. Baseline clinical, pathological and functional characteristics were compared between groups. Endpoints were 30-day postoperative morbidity, cancer-specific-survival (CSS) and overall survival (OS). Kaplan-Meier curves and cox regression analyses were used to evaluate survival and identify predictors of outcome. RESULTS: Median age of the study cohort was 69 years (IQR 63-74). Median duration of follow up was 23 months (IQR 14-35). Thirty-day major postoperative complication rate (Clavien-Dindo grade 3-5) was 17%. Estimated 2-year OS and CSS rates were 73% and 75%, respectively. Baseline characteristics were not different between the MUST groups. OS and CSS were significantly lower (p <0.001) in the malnourished group (MUST ≥1) with medians of 32 months (95%CI 20-44) and 33 months (95%CI 27-46), respectively, compared to the MUST=0 group (medians were not reached, Figure 1). There was no difference in post-operative complication rates between the groups. On multivariable analysis, MUST ≥1 was found to be an independent risk factor for overall-mortality (HR=2.4, 95%CI 1.4-4.2) and cancer-specific-death (HR=2.5, 95% CI 1.4-4.4). CONCLUSIONS: High MUST scores are associated with decreased survival in patients after radical cystectomy. Therefore, the MUST score may assist in perioperative evaluation and patient selection. Future studies should focus on whether improving the nutritional status of malnourished patients will result in improved ontological outcomes. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e762-e762 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Ziv Savin More articles by this author Aviv Kupershmidt More articles by this author Snir Dekalo More articles by this author Dorel Poulin More articles by this author Ofer Yossepowitch More articles by this author Alon Lazarovich More articles by this author Barak Rosenzwieg More articles by this author Reut Shashar More articles by this author Azik Hoffman More articles by this author Jonathan Gal More articles by this author Miki Haifler More articles by this author Roy Mano More articles by this author Expand All Advertisement Loading ...