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International Journal of Clinical Oncology

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01-04-2018 | Original Article

Significance of sarcopenia as a prognostic factor for metastatic urothelial carcinoma patients treated with systemic chemotherapy

Authors: Hideyuki Abe, Kohei Takei, Toshitaka Uematsu, Yuumi Tokura, Issei Suzuki, Kazumasa Sakamoto, Daisaku Nishihara, Yoshiyuki Yamaguchi, Tomoya Mizuno, Akinori Nukui, Minoru Kobayashi, Takao Kamai

Published in: International Journal of Clinical Oncology | Issue 2/2018

Abstract

Background

Recently, numerous studies have reported an association between sarcopenia and poor outcomes in various kinds of malignancies. We investigated whether sarcopenia predicts the survival of patients with metastatic urothelial carcinoma who underwent systemic chemotherapy.

Methods

We reviewed 87 metastatic urothelial carcinoma patients who underwent chemotherapy (gemcitabine plus cisplatin or gemcitabine plus carboplatin for cisplatin-unfit patients) between 2007 and 2015. A computed tomography scan prior to chemotherapy was used for evaluating sarcopenia, and we measured three cross-sectional areas of skeletal muscle at the third lumbar vertebra and calculated the skeletal muscle index (SMI), the paraspinal muscle index (PSMI), and the total psoas area (TPA) of each patient. Predictive values of survival were assessed using Cox regression analysis.

Results

The median overall survival (OS) was 16 months (95% CI 13.5–18). Although SMI alone was not a significant predictor of shorter OS (P = 0.117) in univariate analysis, SMI stratified by the value of the body mass index (BMI) was a significant predictor of shorter OS in univariate analysis (P = 0.037) and was also an independent predictor of shorter OS in multivariate analysis (P = 0.026). PSMI and TPA were not significant prognostic factors even when stratified by BMI (P = 0.294 and 0.448), respectively.

Conclusion

Neither PSMI nor TPA could substitute SMI as a predictor for poor outcomes in metastatic urothelial carcinoma patients treated with systemic chemotherapy in our study. SMI stratified by BMI is a useful predictor of prognosis in these patients.

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Title: Significance of sarcopenia as a prognostic factor for metastatic urothelial carcinoma patients treated with systemic chemotherapy
Authors: Hideyuki Abe
Kohei Takei
Toshitaka Uematsu
Yuumi Tokura
Issei Suzuki
Kazumasa Sakamoto
Daisaku Nishihara
Yoshiyuki Yamaguchi
Tomoya Mizuno
Akinori Nukui
Minoru Kobayashi
Takao Kamai
Publication date: 01-04-2018
Publisher: Springer Japan
Published in: International Journal of Clinical Oncology / Issue 2/2018
Print ISSN: 1341-9625
Electronic ISSN: 1437-7772
DOI: https://doi.org/10.1007/s10147-017-1207-x

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Abstract

Background

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