Decrease in skeletal muscle index 1 year after radical cystectomy as a prognostic indicator in patients with...

Area of Science:

• Oncology
• Geriatrics
• Surgical Oncology

Background:

• Sarcopenia is a growing concern in cancer patients undergoing major surgery.
• Radical cystectomy (RC) for urothelial bladder cancer (UBC) can lead to significant physiological changes.
• The impact of post-operative sarcopenia on long-term outcomes in UBC patients remains under investigation.

Purpose of the Study:

• To investigate the association between sarcopenia after RC and overall survival (OS) in UBC patients.
• To determine if a decrease in skeletal muscle index (SMI) post-RC is a predictor of OS.
• To evaluate the prevalence of sarcopenia before and after RC in this cohort.

Main Methods:

• Prospective measurement of lumbar SMI in 80 UBC patients before and 1 year after RC.
• Assessment of sarcopenia and SMI decrease using Kaplan-Meier analysis.
• Multivariable Cox regression analysis to identify independent prognostic factors for OS.

Main Results:

• Sarcopenia prevalence increased from 32.5% pre-RC to 50.0% post-RC.
• Patients with post-RC sarcopenia had higher tumor stage and grade.
• A decrease in SMI (≥2.2 cm²/m²) was an independent predictor of OS (HR: 2.68, P=0.048).
• Both sarcopenia (P=0.012) and SMI decrease (P=0.025) were associated with significantly different OS rates.

Conclusions:

• Sarcopenia and a decrease in SMI after RC are associated with reduced overall survival in UBC patients.
• SMI decrease post-surgery may serve as a negative prognostic factor for OS.
• These findings highlight the importance of monitoring muscle mass in UBC patients undergoing RC.