Login to Access Video or Poster Abstract: MP21-19
Sources of Funding: none

Introduction

Significant weight loss after surgery is reported to correlate with an increase in post-operative morbidity and mortality. However, there is limited evidence regarding the prevalence of weight loss in patients undergoing radical cystectomy (RC) for bladder cancer. We evaluated post-operative weight loss following RC and ileal neobladder construction, and examined possible association with overall survival outcomes.

Methods

Single institution retrospective observational analysis was performed of patients who underwent RC for muscle invasive bladder cancer, in whom pre- and postoperative weights were documented at regular intervals. Preoperative weight and post-operative weight at 1 week, and 1 month were examined, as well as demographic clinical information. We evaluated weight loss at 1 month, post-operative complications, and relationship between weight loss and prognosis. Overall survival in patients with significant weight loss (=<10% vs. >10%) was estimated using the Kaplan-Meier methods and compared with the log rank test. Risk factors for poor overall survival were determined by multivariate cox regression analysis.

Results

Between March 1996 and Dec 2013, we performed RC in 348 patients and 204 received orthotopic ileal neobladder construction. Of those, a total of 192 patients met the search criteria Weight loss greater than 10% at 1 month was used as the threshold to distinguish patients who had significant weight loss. Patients with significant weight loss had more high-grade complications (? Clavien grade 3) within 1 month (16%% vs 2%, P=0.014), and were significantly poor overall survival (P=0.004). Multivariate analysis showed positive lymph node (HR: 3.2, P=0.009) and postoperative weight loss greater than 10% at 1 month (HR: 3.9, P=0.003) were selected as independent risk factor for overall survival.

Conclusions

Patients experience 5% of weight loss following RC. Patients who experienced > 10% weight loss from baseline at 1 month had increased high-grade complications and experienced poor prognosis. Although the limitations of this study design prevent further understanding of cause and effect, perioperative nutritional optimization may prevent significant weight loss and/or improve outcomes.

Funding

none