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International Journal of Clinical Oncology
Published in: International Journal of Clinical Oncology 1/2020

01-01-2020 | Sarcopenia | Original Article

Sarcopenia as a significant predictive factor of neutropenia and overall survival in urothelial carcinoma patients underwent gemcitabine and cisplatin or carboplatin

Authors: Tetsuya Yumioka, Masashi Honda, Ryoma Nishikawa, Shogo Teraoka, Yusuke Kimura, Hideto Iwamoto, Shuichi Morizane, Katsuya Hikita, Atsushi Takenaka

Published in: International Journal of Clinical Oncology | Issue 1/2020

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Abstract

Background

To evaluate the relationship between sarcopenia and myelosuppression or between sarcopenia and survival outcomes in patients with urothelial carcinoma (UC) undergoing chemotherapy with gemcitabine plus cisplatin (GC) or carboplatin (GCa).

Methods

We evaluated 80 patients with UC who underwent chemotherapy between 2013 and 2017 at our institution. In total, 53 patients had metastatic UC and were ultimately included in the study. Predictive factors for myelosuppression (neutropenia, thrombocytopenia, and anemia) in all patients and overall survival (OS) in metastatic UC patients were analyzed. Sarcopenia was assessed on computed tomography before chemotherapy. Each patient’s total psoas area was measured at the lumbar vertebrae (L3) and sarcopenia was defined as median values or lower. Predictive factors for myelosuppression were assessed using logistic regression analysis and survival was evaluated using Cox regression analysis.

Results

The patients’ mean age was 71.6 years (range 44.4–89.2 years). Of the initial 80 patients, 39 were diagnosed with sarcopenia and 26 of 53 patients with metastatic UC were diagnosed with sarcopenia. Sarcopenia was an independent predictive factor (P = 0.030; odds ratio, 3.526; 95% confidence interval [CI] 1.128–11.01) for neutropenia on multivariate analysis. Patients without sarcopenia had a significantly longer OS compared to those with sarcopenia (P = 0.013). Sarcopenia and albumin (P = 0.045, 0.023; hazard ratio (HR), 2.309, 2.652; 95% CI 1.021–5.225, 1.141–6.165, respectively) were independent predictors of OS in multivariate analysis.

Conclusions

Sarcopenia was predictive for neutropenia associated with GC or GCa in UC patients and OS in metastatic UC.
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Metadata
Title
Sarcopenia as a significant predictive factor of neutropenia and overall survival in urothelial carcinoma patients underwent gemcitabine and cisplatin or carboplatin
Authors
Tetsuya Yumioka
Masashi Honda
Ryoma Nishikawa
Shogo Teraoka
Yusuke Kimura
Hideto Iwamoto
Shuichi Morizane
Katsuya Hikita
Atsushi Takenaka
Publication date
01-01-2020
Publisher
Springer Singapore
Published in
International Journal of Clinical Oncology / Issue 1/2020
Print ISSN: 1341-9625
Electronic ISSN: 1437-7772
DOI
https://doi.org/10.1007/s10147-019-01544-5

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