MP60-08 SARCOPENIA PREDICTS POSTOPERATIVE OUTCOMES FOLLOWING RADICAL CYSTECTOMY

Abstract

You have accessJournal of UrologyBladder Cancer: Invasive III1 Apr 2014MP60-08 SARCOPENIA PREDICTS POSTOPERATIVE OUTCOMES FOLLOWING RADICAL CYSTECTOMY Timothy Lyon, Nicholas Farber, Thomas Fuller, Jeffrey Gingrich, and Tatum Tarin Timothy LyonTimothy Lyon More articles by this author , Nicholas FarberNicholas Farber More articles by this author , Thomas FullerThomas Fuller More articles by this author , Jeffrey GingrichJeffrey Gingrich More articles by this author , and Tatum TarinTatum Tarin More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.1762AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail Introduction and Objectives Sarcopenia, or the loss of skeletal muscle mass, is an indicator of overall nutritional status and can be quantified by measuring skeletal muscle volume on axial imaging. Total psoas area (TPA) has been shown to correlate with postoperative outcomes following surgery for gastrointestinal malignancies. There is limited available data supporting the relationship of TPA to outcomes following radical cystectomy. We sought to further clarify the predictive role of TPA in patients undergoing radical cystectomy for bladder cancer. Methods Following institutional review board approval, a retrospective chart review for all patients who underwent radical cystectomy at our institution in 2011 and 2012 was completed. TPA was measured on preoperative computed tomography (CT) scans at the L3 vertebral level and was then normalized for patient size using body surface area. We performed multivariate logistic regression analysis to evaluate TPA as a predictor of outcomes including postoperative complication rate, length of stay, and overall mortality. Variables including age, gender, BMI, American Society of Anesthesiologists class, diversion type, pathologic stage and TPA were analyzed. Patients were then grouped into TPA tertiles to facilitate comparative analysis. Results A total of 128 patients had data available for analysis. Of these, 20 (15.6%) underwent neoadjuvant chemotherapy. Average total psoas area was 8.43 cm2/m2. On multivariate analysis, TPA was a significant independent predictor of complication rate during the initial postoperative hospitalization (OR 0.726, 95% confidence interval (CI) 0.589 - 0.895, p = 0.002). In comparative analysis, patients in the lowest TPA tertile were significantly more likely to experience a complication than those in the highest tertile (RR 1.61, 95% CI 1.06 – 2.45, p = 0.021). Further, patients in the lowest tertile experienced a significantly longer length of stay (LOS) than those in the highest tertile (8.1 vs. 7.5 days, p = 0.047). Conclusions Low total psoas area was associated with increased complication rate and LOS following cystectomy. TPA is an easily measurable biometric parameter that may be useful in preoperative risk stratification by helping to identify patients most at risk for adverse postoperative outcomes. Future research should focus on further defining the role of sarcopenia in identifying patients who may benefit from preoperative nutritional supplementation. © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e635-e636 Advertisement Copyright & Permissions© 2014MetricsAuthor Information Timothy Lyon More articles by this author Nicholas Farber More articles by this author Thomas Fuller More articles by this author Jeffrey Gingrich More articles by this author Tatum Tarin More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...