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Sarcopenia is associated with survival in patients with urothelial carcinoma treated with systemic chemotherapy. | LitMetric

AI Article Synopsis

  • Sarcopenia, or loss of muscle mass, affects the outcomes of patients undergoing chemotherapy for urothelial carcinoma, potentially influencing their prognosis.
  • A study analyzed 240 patients' muscle mass and survival rates, finding that lower paraspinal muscle index (a measure of muscle mass) was linked to shorter survival times, especially in advanced stages of the disease.
  • The absence of sarcopenia was associated with significantly longer overall survival, indicating that preserving muscle mass could improve outcomes for patients undergoing chemotherapy for this type of cancer.

Article Abstract

Background: Sarcopenia impacts perioperative outcomes and prognosis in various carcinomas. We aimed to investigate whether sarcopenia at the time of chemotherapy induction in patients with urothelial carcinoma is associated with prognosis.

Methods: We evaluated patients treated with chemotherapy for urothelial carcinoma between April 2013 and February 2018 at our institution and affiliated centers. Skeletal muscle mass (total psoas muscle, paraspinal muscle, and total skeletal muscle areas) were used to calculate the total psoas muscle index, paraspinal muscle index, and skeletal muscle index. All participants were grouped as per cutoff points set at the median value for each sex. Overall survival was evaluated using Cox regression analysis.

Results: Of the 240 patients, 171 were men and 69 were women; mean age during chemotherapy was 71 years (range: 43-88); and 36, 56, and 148 patients were at stages II, III, and IV, respectively. Paraspinal muscle index was most associated with the prognosis; groups with lower paraspinal muscle index were defined as sarcopenic (men: ≤ 20.9 cm/m, women: ≤ 16.8 cm/m). The overall survival was significantly longer in the non-sarcopenia group including all stages (p = 0.001), and in stage III (p = 0.048) and IV (p = 0.005) patients. There was no significant difference among stage II patients (p = 0.648). After propensity score matching, survival was still significantly longer in the non-sarcopenia group (p = 0.004).

Conclusions: Paraspinal muscle index measurements obtained during chemotherapy induction for urothelial carcinoma were independent prognostic factors. The absence of sarcopenia may lead to long-term survival in patients undergoing chemotherapy for urothelial carcinoma.

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Source
http://dx.doi.org/10.1007/s10147-021-02032-5DOI Listing

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