Clinical utility of bioelectrical impedance analysis in patients with locoregional muscle invasive or metastatic urothelial carcinoma: a subanalysis of changes in body composition during neoadjuvant systemic chemotherapy

The aim of this study was to determine the clinical utility of bioelectrical impedance analysis (BIA) in a cohort of patients with advanced urothelial carcinoma (UC).

We prospectively evaluated body composition in 35 patients with locoregional muscle invasive (≥ T2 and N0-2M0) or metastatic UC. Body composition was evaluated using multifrequency BIA at baseline (n = 35) and during chemotherapy in patients receiving neoadjuvant chemotherapy (n = 14). The BIA-predicted body composition index was compared with the computed tomography-measured muscle index and the prognostic nutrition index. Changes in body composition during neoadjuvant chemotherapy were recorded and compared with the incidence of hematological adverse events.

There was a significant correlation between the BIA-predicted skeletal muscle index and the computed tomography-measured skeletal muscle index (P = 0.004), while there was no significant correlation between the prognostic nutrition index and the BIA-predicted nutrition index. After the completion of 3 cycles of neoadjuvant chemotherapy, the skeletal muscle index showed a significant decrease (P = 0.016), while the total body fat mass (P = 0.025), body fat percentage (P = 0.013), and body mass index (P = 0.004) showed a significant increase (a tendency toward "sarcopenic obesity"). Patients who experienced grade 2-3 anemia during neoadjuvant chemotherapy showed a significantly lower increase in body mass index compared with patients who did not experience high-grade toxicities (P = 0.032).

BIA could contribute to other methods of nutrition and muscle assessment for pretreatment risk stratification in patients with UC. Further study of a larger cohort is required to elucidate the clinical impact of changes in body composition during chemotherapy.

Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer. 2017 Oct 11 [Epub ahead of print]

Makito Miyake, Takuya Owari, Takashi Iwamoto, Yosuke Morizawa, Shunta Hori, Nagaaki Marugami, Keiji Shimada, Kota Iida, Kenta Ohnishi, Daisuke Gotoh, Yoshihiro Tatsumi, Yasushi Nakai, Takeshi Inoue, Satoshi Anai, Kazumasa Torimoto, Katsuya Aoki, Tatsuo Yoneda, Nobumichi Tanaka, Kiyohide Fujimoto

Department of Urology, Nara Medical University, 840 Shijo-cho, Kashihara-shi, Nara, 634-8522, Japan. ., Department of Urology, Nara Medical University, 840 Shijo-cho, Kashihara-shi, Nara, 634-8522, Japan., Department of Radiology, Nara Medical University, 840 Shijo-cho, Kashihara-shi, Nara, 634-8522, Japan., Department of Pathology, Nara City Hospital, 1-50-1 Higashi kidera-cho, Nara-shi, Nara, 630-8305, Japan.

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