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Sarcopenia as a Novel Preoperative Prognostic Predictor for Survival in Patients with Bladder Cancer Undergoing Radical Cystectomy

  • Urologic Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Purpose

To investigate the prognostic significance of sarcopenia on long-term outcomes in patients with bladder cancer after radical cystectomy (RC).

Methods

We retrospectively reviewed 136 patients undergoing RC for urothelial carcinoma at our institution. Prognostic impact of the preoperative clinical, laboratory, and radiologic parameters were evaluated by Cox proportional hazard model analyses, and a nomogram was developed to predict cancer-specific survival (CSS) after RC.

Results

The mean follow-up was 46.7 months. Patients with sarcopenia had a significantly shorter CSS than those without sarcopenia. On univariate Cox analysis, clinical T stage, histology of transurethral resection of bladder tumor (TURBT) specimen, pretreatment hemoglobin, pretreatment neutrophil-to-lymphocyte ratio (NLR), pretreatment serum C-reactive protein level, pretreatment serum albumin level, presence of hydronephrosis, and presence of sarcopenia were associated with significantly worse CSS. On multivariate Cox stepwise analysis, sarcopenia (hazard rate [HR] = 2.3, p = 0.015), clinical T stage (cT4: HR = 5.3; p = 0.0096), presence of hydronephrosis (HR = 2.0; p = 0.033), histology of TURBT specimen (HR = 2.2, p = 0.044), and NLR (HR = 1.3; p = 0.0048) were significant independent predictors of an unfavorable prognosis Based on the results of the multivariate analysis, we developed a nomogram to predict 1-, 3-, and 5-year CSS after RC.

Conclusions

Sarcopenia, clinical T stage, presence of hydronephrosis, histology of TURBT specimen, and NLR are novel preoperative prognostic factors even after adjustment for other known preoperative predictors in patients undergoing RC for bladder cancer.

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Disclosure

The authors declare no conflict of interest.

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Authors and Affiliations

  1. Department of Urology, Tokyo Medical University, Tokyo, Japan

    Yosuke Hirasawa MD, Jun Nakashima PhD, Toru Sugihara PhD, Tatsuo Gondo PhD, Yoshihiro Nakagami PhD, Yutaka Horiguchi PhD, Yoshio Ohno PhD, Kazunori Namiki PhD, Makoto Ohori PhD & Masaaki Tachibana PhD

  2. Department of Radiology, Tokyo Medical University, Tokyo, Japan

    Daisuke Yunaiyama MD & Koichi Tokuuye PhD

  3. Department of Urology, Sanno Hospital, Tokyo, Japan

    Jun Nakashima PhD

  4. Clinical Medicine Research Center, International University of Health and Welfare, Tokyo, Japan

    Jun Nakashima PhD

Authors
  1. Yosuke Hirasawa MD
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  2. Jun Nakashima PhD
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  3. Daisuke Yunaiyama MD
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  4. Toru Sugihara PhD
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  5. Tatsuo Gondo PhD
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  6. Yoshihiro Nakagami PhD
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  7. Yutaka Horiguchi PhD
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  12. Masaaki Tachibana PhD
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Correspondence to Yosuke Hirasawa MD.

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Hirasawa, Y., Nakashima, J., Yunaiyama, D. et al. Sarcopenia as a Novel Preoperative Prognostic Predictor for Survival in Patients with Bladder Cancer Undergoing Radical Cystectomy. Ann Surg Oncol 23 (Suppl 5), 1048–1054 (2016). https://doi.org/10.1245/s10434-016-5606-4

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  • DOI: https://doi.org/10.1245/s10434-016-5606-4

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