We sought to investigate the incidence of sarcopenia and its impact on main oncological outcomes in patients with muscle invasive bladder cancer (MIBC) treated with trimodal therapy (TMT).
This was a retrospective analysis of 141 MIBC patients treated with TMT in the period 2002 to 2018. Sarcopenia was identified through pretreatment computed tomography scans and defined as a skeletal muscle index of <55 cm2/m2 for men and <39 cm2/m2 for women. Body mass index (BMI)-adjusted definition of sarcopenia was used to evaluate for sarcopenic obesity. Uni- and multivariable analyses were performed to assess the impact of sarcopenia on initial complete response and overall survival (OS) to TMT.
Median age at diagnosis was 73 years [range: 65-81] and median follow up was 32 months (Inter Quartile Range: 18-66). Median OS was 67 months (95% CI: 53-83). The incidence of sarcopenia and BMI-adjusted sarcopenia was 56.7% and 40.4%, respectively. On multivariable analysis, Eastern Cooperative Oncology Group performance status (HR = 2.37, 95% CI: 2.1-5.67, P = 0.001) and complete response to treatment (HR = 0.26, 95% CI: 0.14-0.049, P = 0.001] were independently associated with improved OS. Sarcopenia and BMI-adjusted sarcopenia were not independently associated with either complete response to TMT or OS. Similarly, in a subpopulation of 74 patients considered fit for radical cystectomy, we found that neither sarcopenia (P = 0.49) nor BMI-adjusted sarcopenia (P = 0.22) had an impact on OS.
Sarcopenia and BMI-adjusted sarcopenia are prevalent in patients with MIBC undergoing TMT. TMT is a suitable treatment modality for patients with MIBC irrespective of their sarcopenia status.
Urologic oncology. 2021 Nov 30 [Epub ahead of print]
Ahmad Almarzouq, Ronald Kool, Yarab Al Bulushi, Gautier Marcq, Luis Souhami, Fabio L Cury, Fadi Brimo, Jaron Chong, Wassim Kassouf
Division of Urology, McGill University Health Centre, Montreal, Canada., Department of Diagnostic Radiology, McGill University Health Centre, Montreal, Canada., Division of Urology, McGill University Health Centre, Montreal, Canada; Univ. Lille, CNRS, Inserm, CHU Lille, Institut Pasteur de Lille, Lille, France; Urology Department, Claude Huriez Hospital, Lille, France., Department of Radiation Oncology, McGill University Health Centre, Montreal, Canada., Department of Pathology, McGill University Health Centre, Montreal, Canada., Department of Medical Imaging, Western University, London, Ontario, Canada., Division of Urology, McGill University Health Centre, Montreal, Canada. Electronic address: .