Sarcopenia as a comorbidity-independent predictor of survival following radical cystectomy for bladder cancer.
Sarcopenia as a comorbidity-independent predictor of survival following radical cystectomy for bladder cancer.
复制标题
DOI：
10.1002/jcsm.12279
复制
发表时间：
2018-06
期刊：
影响因子：
--
通讯作者：
Martini T
中科院分区：
文献类型：
--
作者：
Mayr R;Gierth M;Zeman F;Reiffen M;Seeger P;Wezel F;Pycha A;Comploj E;Bonatti M;Ritter M;van Rhijn BWG;Burger M;Bolenz C;Fritsche HM;Martini T
开展了一项多中心研究，以调查石棉减少作为膀胱癌根治性膀胱切除术后肿瘤预后的独立预测因子的影响。总共确定了500名在手术前90天内获得腹部数字计算机断层扫描的患者。术前用计算机断层扫描测量腰椎骨骼肌指数。采用Kaplan-Meier曲线估计肿瘤特异性生存期(CS)和总生存期(OS)。用单因素和多因素COX回归模型分析影响CS和OS的因素。根据骨骼肌指数，189例(37.8%)患者被归类为骨质疏松症。骨质疏松症患者年龄较大(P=0.002)，但两组在性别、合并症、肿瘤、淋巴结转移、转移分期和尿流改道类型方面具有可比性(均P<0.05)。总共有234名患者(46.8%)死亡，其中145名(29.0%)死于膀胱尿路上皮癌。与无石棺减少的患者相比，石棺减少患者的5年OS(38.3%比50.5%；P=0.002)和5年CS(49.5%比62.3%；P=0.016)明显差。此外，骨质疏松症与全因死亡率增加(危险比1.43；95%可信区间1.09-1.87；P0.01)和癌症特异性死亡率增加(危险比1.42；95%可信区间1.00-2.02；P=0.048)独立相关。我们的结果受到缺乏前瞻性脆弱性评估的限制。在一项对接受膀胱癌根治性膀胱切除术的患者进行的大型多中心研究中，肌量减少已被证明是OS和CS的独立预测因子。
A multicentre study was conducted to investigate the impact of sarcopenia as an independent predictor of oncological outcome after radical cystectomy for bladder cancer. In total, 500 patients with available digital computed tomography scans of the abdomen obtained within 90 days before surgery were identified. The lumbar skeletal muscle index was measured using pre‐operative computed tomography. Cancer‐specific survival (CSS) and overall survival (OS) were estimated using Kaplan–Meier curves. Predictors of CSS and OS were analysed by univariable and multivariable Cox regression models. Based on skeletal muscle index, 189 patients (37.8%) were classified as sarcopenic. Patients with sarcopenia were older compared with their counterparts (P = 0.002), but both groups were comparable regarding to gender, comorbidity, tumor, node, metastasis (TNM) stage, and type of urinary diversion (all P > 0.05). In total, 234 (46.8%) patients died, and of these, 145 (29.0%) died because of urothelial carcinoma of the bladder. Sarcopenic patients had significantly worse 5 year OS (38.3% vs. 50.5%; P = 0.002) and 5 year CSS (49.5% vs. 62.3%; P = 0.016) rates compared with patients without sarcopenia. Moreover, sarcopenia was associated independently with both increased all‐cause mortality (hazard ratio, 1.43; 95% confidence interval 1.09–1.87; P = 0.01) and increased cancer‐specific mortality (hazard ratio, 1.42; 95% confidence interval, 1.00–2.02; P = 0.048). Our results are limited by the lack of prospective frailty assessment. Sarcopenia has been shown to be an independent predictor for OS and CSS in a large multicentre study with patients undergoing radical cystectomy for bladder cancer.
登录
查看更多内容
影响因子：
3.2
作者：
Martini, Thomas;Gilfrich, Christian;Bolenz, Christian
通讯作者：
Bolenz, Christian
影响因子：
45.3
作者：
Madersbacher, S;Hochreiter, W;Studer, UE
通讯作者：
Studer, UE
影响因子：
23.4
作者：
Reardon, Zachary D.;Patel, Sanjay G.;Zaid, Harras B.;Stimson, C. J.;Resnick, Matthew J.;Keegan, Kirk A.;Barocas, Daniel A.;Chang, Sam S.;Cookson, Michael S.
通讯作者：
Cookson, Michael S.
影响因子：
6.6
作者：
Boorjian, Stephen A.;Kim, Simon P.;Frank, Igor
通讯作者：
Frank, Igor
DOI：
10.1016/j.jamda.2010.04.014
发表时间：
2010-07
影响因子：
7.6
作者：
Morley JE;Argiles JM;Evans WJ;Bhasin S;Cella D;Deutz NE;Doehner W;Fearon KC;Ferrucci L;Hellerstein MK;Kalantar-Zadeh K;Lochs H;MacDonald N;Mulligan K;Muscaritoli M;Ponikowski P;Posthauer ME;Rossi Fanelli F;Schambelan M;Schols AM;Schuster MW;Anker SD;Society for Sarcopenia, Cachexia, and Wasting Disease
通讯作者：
Society for Sarcopenia, Cachexia, and Wasting Disease