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
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
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DOI：
10.1007/s00520-017-3924-0
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发表时间：
2018-04-01
影响因子：
3.1
通讯作者：
Fujimoto, Kiyohide
中科院分区：
文献类型：
--
作者：
Miyake, Makito;Owari, Takuya;Fujimoto, Kiyohide
本研究的目的是确定生物电阻抗分析（BIA）在晚期尿路上皮癌（UC）患者队列中的临床效用。我们前瞻性地评估了35例局部肌肉浸润性（T2和N 0 - 2 M0）或转移性UC患者的身体组成。在接受新辅助化疗的患者中，在基线（n = 35）和化疗期间（n = 14）使用多频BIA评估身体组成。将BIA预测的身体成分指数与计算机断层扫描测量的肌肉指数和预后营养指数进行比较。记录新辅助化疗期间身体成分的变化，并与血液学不良事件的发生率进行比较，BIA预测的骨骼肌指数与CT测量的骨骼肌指数之间存在显著相关性（P = 0.004），而预后营养指数与BIA预测的营养指数之间无显著相关性。完成3个周期的新辅助化疗后，骨骼肌指数显示出显著降低（P = 0.016），而总体脂量（P = 0.025）、体脂百分比（P = 0.013）和体重指数（P = 0.004）显示出显著增加（向“肌肉减少性肥胖”的趋势）。新辅助化疗期间发生2-3级贫血的患者与未发生高级别毒性的患者相比，体重指数的增加显著较低（P = 0.032）。BIA可能有助于UC患者治疗前风险分层的其他营养和肌肉评估方法。需要对更大的队列进行进一步研究，以阐明化疗期间身体成分变化的临床影响。
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.