Psoas Muscle Mass can Predict Postsurgical Outcomes in Patients Who Undergo Radical Cystectomy and Urinary Diversion Reconstruction - 09/12/21
Abstract |
Objective |
To morphometrically measure to muscle mass which may reflect physical components of frailty. Hence, we evaluated the association between L4 total psoas area (TPA) and operative outcome after radical cystectomy (RC) for bladder cancer.
Methods |
In a retrospective single-center study, bladder cancer patients who underwent RC and urinary diversion between 2007 and 2012 were enrolled. TPA was evaluated in the cross-sectional imaging. The psoas muscles were normalized with the height. Male patients with a psoas mass index ≤7.4 cm2/m2 and female patients with a psoas mass index ≤5.2 cm2/m2 were classified as sarcopenic. Outcome measures were 30- and 90-day readmission and complications, and survival. Multivariable logistic and Cox proportional-hazards regression models were used to determine relevant predictors.
Results |
The median age of the 441 participants and follow up time was 68 years (IQR 59-75) and 1.2 years (IQR 0.5-1.9), respectively. One hundred forty-three patients (32.4%) were sarcopenic. The 30-day readmission and the complication rates were 13.8% and 44.7%, respectively. The 90-day readmission and complication rates were 23.9% and 53.1%, respectively. The 1-year mortality rate was 11.6% (95%CI 8.7-15.4). Multivariable logistic regression analysis revealed an association between increased TPA and lower odds of 30-day complications after RC (OR 0.95, 95%CI 0.92-0.99, P = .02); similarly, an increase in TPA was of prognostic value, although not statistically significant in the multivariable model (P = .05) once adjusting for other patient factors.
Conclusion |
Sarcopenia predicted early complications and showed an informative trend for overall survival after RC, and thus may inform models predicting postsurgical outcomes.
Le texte complet de cet article est disponible en PDF.Plan
| Protection of Human and Animal Subjects: The investigation was performed after approval by the institutional review board. |
|
| Funding: No external funding was received for the work. |
|
| Conflict of interests: Stewart C. Wang: inventor of analytic morphomics and equity holder in Applied Morphomics, Inc., which has licensed morphomics from the University of Michigan. All other authors state having no conflict of interest. |
|
| Table of Content: - A decreased psoas muscle mass is prevalent in about a third of patients undergoing radical cystectomy. - In the present sizable US population, sarcopenia was of prognostic value for the occurrence of early complications and showed an informative trend for overall survival after surgery in patients with urothelial bladder cancer. |
Vol 158
P. 142-149 - décembre 2021 Retour au numéro
Article précédent
- Does Switching Bacillus Calmette-Guerin Strains During Maintenance Therapy Affect the Outcome in Non-Muscle Invasive Bladder Cancer?
- Evren Süer, Murat Can Karaburun, Muammer Babayi?it, Ça?r? Akp?nar, Mehmet ?lker Gökçe, Ömer Gülp?nar, Kadir Türkölmez, Sümer Baltac?
- Comparison of Multi-Parametric MRI of the Prostate to 3D Prostate Computer Aided Designs and 3D-Printed Prostate Models for Pre-Operative Planning of Radical Prostatectomies: A Pilot Study
- Patrick Saba, Rachel Melnyk, Tyler Holler, Daniel Oppenheimer, Nathan Schuler, William Tabayoyong, Jonathan Bloom, Jathin Bandari, Thomas Frye, Jean Joseph, Eric Weinberg, Gary Hollenberg, Ahmed Ghazi
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?