You have accessJournal of UrologyCME1 May 2022MP46-12 DECLINES IN SKELETAL MUSCLE MASS AND QUALITY DURING CYTOTOXIC CHEMOTHERAPY PREDICT INCREASED RISK OF CHEMOTHERAPY-ASSOCIATED ADVERSE EVENTS IN MEN WITH TESTIS CANCER Anthea Phuong, J. Peter Marquardt, Florian J. Fintelmann, Ryan O'Malley, Grace Laidlaw, Zachary Eagle, Steven Ngo, Sarah Holt, Delaney Orcutt, George R. Schade, Daniel W. Lin, Michael T. Schweizer, Todd Yezefski, Evan Y. Yu, Bruce Montgomery, Petros Grivas, and Sarah Psutka Anthea PhuongAnthea Phuong More articles by this author , J. Peter MarquardtJ. Peter Marquardt More articles by this author , Florian J. FintelmannFlorian J. Fintelmann More articles by this author , Ryan O'MalleyRyan O'Malley More articles by this author , Grace LaidlawGrace Laidlaw More articles by this author , Zachary EagleZachary Eagle More articles by this author , Steven NgoSteven Ngo More articles by this author , Sarah HoltSarah Holt More articles by this author , Delaney OrcuttDelaney Orcutt More articles by this author , George R. SchadeGeorge R. Schade More articles by this author , Daniel W. LinDaniel W. Lin More articles by this author , Michael T. SchweizerMichael T. Schweizer More articles by this author , Todd YezefskiTodd Yezefski More articles by this author , Evan Y. YuEvan Y. Yu More articles by this author , Bruce MontgomeryBruce Montgomery More articles by this author , Petros GrivasPetros Grivas More articles by this author , and Sarah PsutkaSarah Psutka More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002612.12AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Baseline muscle mass (skeletal muscle index, SMI) is associated with outcomes across malignancies. The novel concept of skeletal muscle gauge (SMG=SMI*skeletal muscle density (SMD)) is proposed as a composite measure for muscle quality and quantity. To date, changes in SMI and SMI during cytotoxic chemotherapy (CC) in germ cell carcinoma of testis (GCT) remain undescribed. Herein, our objective was to quantify changes in SMI and SMG in men with GCT undergoing CC and evaluate associations between these measures and CC-associated adverse events (AE). METHODS: All consecutive men undergoing CC for GCT (2005-18) were retrospectively reviewed. Third lumbar SMI (cm2/m2) and SMD (HU) were obtained using validated methodology on axial computed tomography (CT) images within 75 days prior to the start (T1) and after the end (T2) of CC from which SMG was calculated. Changes in SMI, SMD, and SMG were quantified and associations with grade 1-5 AEs (CTCAE v.5) were estimated with multivariable logistic regression. RESULTS: This study of 141 men with median age of 30 years (IQR 25-39) included 61% with nonseminomatous GCT. Tumors were classified as Stage IS, II, and III GCT in 21%, 41%, and 38%, respectively. CC regimens included BEP (68%), EP (17%), VIP (8%), and other (6%) with median of 3-cycles; 90% of patients completed planned CC. Median time between CTs was 107 days. Median SMI-T1 and -T2 were 57.9 and 55.3 cm2/m2 (∆SMI -6%), median SMD-T1 and -T2 were 57 and 54 HU (∆SMD -2%), and median SMG-T1 and -T2 were 3256 and 3059 (∆SMG -6%, Figure). Overall, 120 men (85%) experienced at least one AE. On multivariable analysis adjusted for age, ECOG performance status, Charlson Comorbidity Index, CC type, and GCT stage, ∆SMI (OR 1.19; 95% CI 1.04-1.35, p=0.002) and ∆SMG (OR (/100-unit increments): 1.14; 95% CI 1.01-1.28, p=0.02) were independently associated with risk of AE. CONCLUSIONS: On average, men with GCT demonstrate declines in skeletal muscle mass and quality during CC, which are independently associated with risk of chemotherapy-associated AEs. Further work is needed to understand the risk factors for loss of muscle mass and quality during CC and to determine optimal interventions to mitigate these losses. Source of Funding: none © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e777 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Anthea Phuong More articles by this author J. Peter Marquardt More articles by this author Florian J. Fintelmann More articles by this author Ryan O'Malley More articles by this author Grace Laidlaw More articles by this author Zachary Eagle More articles by this author Steven Ngo More articles by this author Sarah Holt More articles by this author Delaney Orcutt More articles by this author George R. Schade More articles by this author Daniel W. Lin More articles by this author Michael T. Schweizer More articles by this author Todd Yezefski More articles by this author Evan Y. Yu More articles by this author Bruce Montgomery More articles by this author Petros Grivas More articles by this author Sarah Psutka More articles by this author Expand All Advertisement PDF DownloadLoading ...