Department of Urology, The Second Hospital of Tianjin Medical University, NO. 23, Pingjiang Road, Hexi District, Tianjin, 300211, China.
Department of Endocrinology, Tianjin Union Medical Center, Nankai University Affiliated Hospital, Tianjin, China.
Support Care Cancer. 2022 Feb;30(2):1191-1198. doi: 10.1007/s00520-021-06423-2. Epub 2021 Aug 28.
Sarcopenia has been proved to be related to the prognosis of patients with bladder cancer (BC) after radical cystectomy (RC). The relationship between sarcopenia and the occurrence of venous thromboembolism (VTE) after RC is unclear.
We collected data of 252 BC patients treated with RC at our institution. Data was obtained from the electronic medical record database. Sarcopenia was defined by the third lumbar vertebra skeletal muscle index (SMI) which was measured using preoperative computed tomography. The primary outcome was the incidence of VTE within 30 days after the surgery in sarcopenia and non-sarcopenia groups. Outcomes between the two cohorts were compared using univariate analysis. Multivariate logistic regression was used to control for differences between cohorts.
Two hundred fifty-two patients were enrolled, of which 85 (33.7%) patients were in sarcopenia group, while 167 (66.3%) patients were not in sarcopenia group. The incidence of total VTE in sarcopenia group was higher than that in the extended group (10.6% vs. 1.8%, p = 0.005). Sarcopenia did not cause an increase in other postoperation 30 days complications (all p > 0.05). Multivariate analysis confirmed sarcopenia was independently associated with increased odds of VTE (OR = 4.18, 95% CI [1.01-17.27]; p = 0.048). Subgroup analysis showed that patients with VTE tended to be older (76.5 vs 66.0, p = 0.025) and have higher proportion of diabetes (58.3% vs 14.2%, p < 0.001) as well as lower level of serum albumin (35.0 g/L vs 40.4 g/L, p = 0.023) compared with those without VTE.
Sarcopenia was an independent predictor for VTE with patients undergoing RC for BC.
肌肉减少症已被证明与接受根治性膀胱切除术（RC）后的膀胱癌（BC）患者的预后有关。肌肉减少症与 RC 后静脉血栓栓塞（VTE）的发生之间的关系尚不清楚。
我们收集了在我院接受 RC 治疗的 252 例 BC 患者的数据。数据来自电子病历数据库。肌肉减少症通过术前 CT 测量的第三腰椎骨骼肌指数（SMI）定义。主要结局是手术 30 天内 VTE 的发生率，比较两组的结局。使用单变量分析比较两组间的差异。使用多变量逻辑回归控制队列间的差异。
共纳入 252 例患者，其中 85 例（33.7%）为肌肉减少症组，167 例（66.3%）为非肌肉减少症组。肌肉减少症组总 VTE 的发生率高于非肌肉减少症组（10.6%比 1.8%，p=0.005）。肌肉减少症并未导致其他术后 30 天并发症发生率增加（均 p>0.05）。多变量分析证实，肌肉减少症与 VTE 的发生几率增加独立相关（OR=4.18，95%CI[1.01-17.27]；p=0.048）。亚组分析显示，VTE 患者年龄较大（76.5 岁比 66.0 岁，p=0.025）、糖尿病比例较高（58.3%比 14.2%，p<0.001）和血清白蛋白水平较低（35.0g/L 比 40.4g/L，p=0.023）。
肌肉减少症是 BC 患者接受 RC 后 VTE 的独立预测因子。
