A low psoas muscle volume correlates with a longer hospitalization after radical cystectomy

Recently, sarcopenia has been reported as a new predictor for patient outcomes or likelihood of post-operative complications. The purpose of this study was to evaluate the association of the psoas muscle volume with the length of hospitalization among patients undergoing radical cystectomy.

A total of 63 (80.8%) male patients and 15 (19.2%) female patients who underwent radical cystectomy for their bladder cancer in our institution from 2000 to 2015 were analyzed. The psoas muscle index (PMI) was calculated by normalizing the psoas muscle area calculated using axial computed tomography at the level of the umbilicus (cm(2)) by the square of the body height (m(2)). Longer hospitalization was defined as hospitalization exceeding 30 days after surgery.

The median PMIs (mean ± standard deviation) were 391 (394 ± 92.1) and 271 (278 ± 92.6) cm(2)/m(2) in men and women, respectively. Thus, the PMIs of male patients were significantly larger than those of females (p < 0.001). Based on the differences in gender, we analyzed 63 male patients for a further analysis. In male patients, those hospitalized longer showed a significantly smaller PMI than those normally discharged (377 ± 93.1 vs. 425 ± 83.4; p = 0.04). Similarly, male patients with a small PMI (<400) had a significantly worse overall survival (p = 0.02) than those with a large PMI (≥400).

The presence of sarcopenia was found to be associated with significantly longer hospitalization after radical cystectomy in male patients. Furthermore, in men, a PMI <400 may suggest a significantly worse prognosis.

BMC urology. 2017 Sep 18*** epublish ***

Yoko Saitoh-Maeda, Takashi Kawahara, Yasuhide Miyoshi, Sohgo Tsutsumi, Daiji Takamoto, Kota Shimokihara, Yuutaro Hayashi, Taku Mochizuki, Mari Ohtaka, Manami Nakamura, Yusuke Hattori, Jun-Ichi Teranishi, Yasushi Yumura, Kimito Osaka, Hiroki Ito, Kazuhide Makiyama, Noboru Nakaigawa, Masahiro Yao, Hiroji Uemura

Departments of Urology and Renal Transplantation, Yokohama City University Medical Center, 4-57 Urafune-cho, Minami-ku, Yokohama, Kanagawa, 2320024, Japan., Departments of Urology and Renal Transplantation, Yokohama City University Medical Center, 4-57 Urafune-cho, Minami-ku, Yokohama, Kanagawa, 2320024, Japan. ., Department of Urology, Yokohama City University Graduate School of Medicine, Yokohama, Japan.

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