Lower skeletal muscle index and early complications in patients undergoing radical cystectomy for bladder cancer

World Journal of Surgical Oncology

Research

Jingyi Cheng¹  Chengyuan Gu²  Yao Zhu²  Bo Dai²  Yijun Shen²  Shilin Zhang²  Xudong Yao²  Dingwei Ye²  Fangning Wan²  Hailiang Zhang² 

[1] Department of Nuclear Medicine, Fudan University Shanghai Cancer Center, Shanghai, China;Department of Urology, Fudan University Shanghai Cancer Center, No. 270 Dong’an Road, 200032, Shanghai, People’s Republic of China;Department of Oncology, Fudan University Shanghai Medical College, Shanghai, China;

关键词: Bladder cancer;    Radical cystectomy;    SMI;    Postoperative complications;    Sarcopenia;   

DOI  :  10.1186/1477-7819-12-14

 received in 2013-08-05, accepted in 2014-01-03,  发布年份 2014

来源: Springer

【 摘 要 】

BackgroundRadical cystectomy (RC) is the standard treatment for patients with muscle-invasive bladder cancer (BC), and it is also a valid option for selected patients with high-risk non-muscle-invasive BC. The purpose of this study was to evaluate the effect on the lower skeletal muscle index (SMI) of short-term postoperative complications of radical cystectomy (RC) in patients with bladder cancer (BC).MethodsA total of 247 patients who received RC for BC and 204 age-matched healthy population-based controls were retrospectively assessed. SMI was measured by preoperative computed tomography scans at the L4 to L5 level. Early complications were graded by Clavien-Dindo classification; severity of grade III or greater was identified as a severe complication. Logistic regression was utilized to determine the relationships between covariables and severe complications.ResultsA total of 125 (50.61%)/19 (7.69%) patients exhibited overall/severe complications during the early postoperative period. SMI was strongly associated with gender (P <0.01), but not age and body mass index (BMI), among patients with BC. Compared with the matched control group, BC patients exhibited lower SMI. The difference was statistically significant in the subgroup of male patients (P = 0.03). In the multivariate analysis, SMI was an independent predictor of developing severe complications. Each 1 cm2/m2 increase in SMI was associated with a decrease in the odds of morbidity by 4.8%.ConclusionsA lower SMI is frequently observed in bladder cancer patients undergoing RC and is shown to be strongly associated with early complications following surgery.

【 授权许可】

Unknown   
© Wan et al.; licensee BioMed Central Ltd. 2014. This article is published under license to BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.