Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Korea.
Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Korea.
J Cancer Res Clin Oncol. 2024 Apr 3;150(4):173. doi: 10.1007/s00432-024-05705-6.
This retrospective study aimed to assess the correlation between preoperative sarcopenia and long-term oncologic outcomes in patients undergoing radical cystectomy for bladder cancer.
We included 528 patients who underwent radical cystectomy for bladder cancer between 2000 and 2010 at Asan Medical Center, Seoul, Korea. Preoperative skeletal muscle mass was quantified by analyzing computed tomography images at the third lumbar vertebra. Sarcopenia was defined based on the skeletal muscle index. We evaluated various clinical and pathological factors to analyze the association between sarcopenia and long-term oncologic outcomes.
The median follow-up time was 104 months. Sarcopenia was identified in 37.9% of the patients. Although no significant differences were observed in traditional pathological factors between the sarcopenic and non-sarcopenic groups, sarcopenia was significantly associated with worse oncologic outcomes. Compared to the non-sarcopenic groups, the sarcopenic group had lower overall survival rates (52.0% vs. 67.1% at 5 years, 35.5% vs. 52.7% at 10 years) and higher cancer-specific mortality (63.3% vs. 74.3% at 5 years, 50.7% vs. 67.4% at 10 years). Multivariable Cox regression analysis demonstrated that sarcopenia was an independent predictor of cancer-specific survival (hazard ratio: 1.49, 95% confidence interval: 1.11-2.01, p = 0.008), alongside body mass index, tumor stage, lymph node metastasis, and lymphovascular invasion.
Sarcopenia was significantly associated with poor cancer-specific survival in patients undergoing radical cystectomy for bladder cancer. Detecting sarcopenia may assist in preoperative risk stratification and long-term management after radical cystectomy.
本回顾性研究旨在评估膀胱癌根治性切除术患者术前肌少症与长期肿瘤学结局的相关性。
我们纳入了 2000 年至 2010 年在韩国首尔峨山医学中心接受膀胱癌根治性切除术的 528 例患者。通过分析第 3 腰椎的 CT 图像来量化术前骨骼肌质量。根据骨骼肌指数定义肌少症。我们评估了各种临床和病理因素，以分析肌少症与长期肿瘤学结局之间的关系。
中位随访时间为 104 个月。37.9%的患者存在肌少症。虽然在传统的病理因素方面，肌少症组与非肌少症组之间没有显著差异，但肌少症与较差的肿瘤学结局显著相关。与非肌少症组相比，肌少症组的总生存率较低（5 年时为 52.0% vs. 67.1%，10 年时为 35.5% vs. 52.7%），癌症特异性死亡率较高（5 年时为 63.3% vs. 74.3%，10 年时为 50.7% vs. 67.4%）。多变量 Cox 回归分析表明，肌少症是癌症特异性生存的独立预测因素（风险比：1.49，95%置信区间：1.11-2.01，p=0.008），与体重指数、肿瘤分期、淋巴结转移和脉管侵犯并列。
肌少症与膀胱癌根治性切除术患者的癌症特异性生存不良显著相关。检测肌少症可能有助于术前风险分层和根治性膀胱切除术后的长期管理。
