MP72-13 AI CHARACTERIZATION OF LONGITUDINAL CHANGES IN BODY COMPOSITION: PREDICTORS OF CHANGE AFTER RADICAL CYSTECTOMY

Abstract

You have accessJournal of UrologyCME1 Apr 2023MP72-13 AI CHARACTERIZATION OF LONGITUDINAL CHANGES IN BODY COMPOSITION: PREDICTORS OF CHANGE AFTER RADICAL CYSTECTOMY Anthony Fadel, Vidit Sharma, Matthew K. Tollefson, Daniel J. Blezek, Robert F. Tarrell, Prabin Thapa, Lyndsay D. Viers, Aaron M. Potretzke, Stephen A. Boorjian, Igor Frank, Robert P. Hartman, and Boyd R. Viers Anthony FadelAnthony Fadel More articles by this author , Vidit SharmaVidit Sharma More articles by this author , Matthew K. TollefsonMatthew K. Tollefson More articles by this author , Daniel J. BlezekDaniel J. Blezek More articles by this author , Robert F. TarrellRobert F. Tarrell More articles by this author , Prabin ThapaPrabin Thapa More articles by this author , Lyndsay D. ViersLyndsay D. Viers More articles by this author , Aaron M. PotretzkeAaron M. Potretzke More articles by this author , Stephen A. BoorjianStephen A. Boorjian More articles by this author , Igor FrankIgor Frank More articles by this author , Robert P. HartmanRobert P. Hartman More articles by this author , and Boyd R. ViersBoyd R. Viers More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003340.13AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Long term body composition changes after radical cystectomy (RCx) are unknown. Herein, we characterize changes in body composition over one year after RCx and determine predictors of unfavorable change in radiographic nutritional indices. METHODS: CT images for 843 RCx patients from 2009-2017 were collected at baseline, 3 months, and 1 year. Artificial intelligence algorithms extracted two-dimensional axial skeletal muscle and adipose areas at the L3 level. Skeletal muscle index (SMI) and fat mass index (FMI) were calculated, and multivariable logistic regression models were performed to determine factors associated with unfavorable body composition change: absolute top tertile change in FMI and SMI. RESULTS: Muscle and fat body parameters decreased from baseline to 3 months but increased from 3 months to 1 year (Figure 1). However, the distributions of changes in SMI and FMI across these timepoints (Figure 2) show that some patients were able to maintain muscle and fat mass after surgery. In the first 3 months, increasing age and higher BMI were associated with greater loss in FMI (odds ratio (OR) < 1, p<.05); while neoadjuvant chemotherapy was associated with increased gains (OR 1.5, p=.03). After 3 months, robotic surgery was associated with greater gains in FMI (OR 1.8, p=.03). In the first 3 months, on multivariable analysis, men (OR 2.06), increasing BMI (OR 1.08), neoadjuvant chemotherapy (OR 3.98), and any 30-day complications (OR 1.79) were associated with greater loss in SMI from baseline to 3 months (p<.05 for all). After 3 months, older patients had smaller gains in SMI (p<.05), as did patients with bladder cancer recurrences (p<.05). On the contrary, patients with continent diversion were associated with greater gains in SMI (p<.05). CONCLUSIONS: Long-term changes in body composition after RCx are common, and clinically relevant predictors of unfavorable body composition change were identified indicating a catabolic state. Individualized rehabilitation interventions based on these predictors warrants further study. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e1029 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Anthony Fadel More articles by this author Vidit Sharma More articles by this author Matthew K. Tollefson More articles by this author Daniel J. Blezek More articles by this author Robert F. Tarrell More articles by this author Prabin Thapa More articles by this author Lyndsay D. Viers More articles by this author Aaron M. Potretzke More articles by this author Stephen A. Boorjian More articles by this author Igor Frank More articles by this author Robert P. Hartman More articles by this author Boyd R. Viers More articles by this author Expand All Advertisement PDF downloadLoading ...