MP55-03 SARCOPENIA IS A PROGNOSTIC BIOMARKER OF ADVANCED UROTHELIAL CARCINOMA

Abstract

You have accessJournal of UrologyBladder Cancer: Invasive II1 Apr 2014MP55-03 SARCOPENIA IS A PROGNOSTIC BIOMARKER OF ADVANCED UROTHELIAL CARCINOMA Hiroshi Fukushima, Minato Yokoyama, and Fumitaka Koga Hiroshi FukushimaHiroshi Fukushima More articles by this author , Minato YokoyamaMinato Yokoyama More articles by this author , and Fumitaka KogaFumitaka Koga More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.1551AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail Introduction and Objectives Inoperable urothelial carcinoma (UC) patients due to metastatic and/or locoregionally advanced disease show poor prognosis despite recent improvements in multidisciplinary strategies. Pretreatment risk assessment based on prognosticators is required to offer such patients better therapeutic options including clinical trials. Sarcopenia, degenerative loss of skeletal muscle mass, is an objective indicator of cachexia. Few data exist on its prognostic value. Here, we investigated the role of sarcopenia as a prognostic biomarker in advanced UC patients. Methods This retrospective study consisted of 88 UC patients with cT4 or metastases to lymph nodes/distant organs, treated at our institution from 2004 to 2012. Variables included age, sex, performance status (PS), body mass index (BMI), hemoglobin, white blood cell count, creatinin, albumin, C-reactive protein (CRP), alkaline phosphatase (ALP), lactate dehydrogenase (LDH), corrected calcium, presence of hydronephrosis, primary site, presence of lymph node or distant metastasis, prior curative surgery and any therapies for advanced disease. The L3 muscle index (cm2/m2) was calculated by normalizing skeletal muscle areas at the L3 vertebra level on CT images for height. Sarcopenia was defined as the L3 muscle index of 38.5 cm2/m2 for women and 52.4 cm2/m2 for men. We examined associations of sarcopenia with overall survival (OS) using Cox regression analysis. Results Of the 88 patients, 35 (40%) were assigned as sarcopenia. Sarcopenia was significantly associated with lower BMI (p < .0001), poorer PS (p = .002), advanced age (p = .01), lower albumin (p = .01), presence of distant metastasis (p = .02), higher ALP (p = .02) and higher CRP (p = .045). During the median follow-up of 13 m, 66 patients (75%) died. On multivariate analysis, sarcopenia was an independent predictor of shorter OS (HR 11.36, p < .0001), along with higher LDH (p = .001), higher ALP (p = .002), no therapies for advanced disease (p = .009), upper urinary tract cancer (p = .01), presence of lymph node metastasis (p = .02) and higher CRP (p = .04). Median OS was 10 and 33 m for patients with and without sarcopenia, respectively (p < .0001). Conclusions This is the first to show prognostic significance of sarcopenia in advanced UC. Sarcopenia, which is evaluated on routine CT scan, is a useful prognostic biomarker of advanced UC. © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e556 Advertisement Copyright & Permissions© 2014MetricsAuthor Information Hiroshi Fukushima More articles by this author Minato Yokoyama More articles by this author Fumitaka Koga More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...