Login to Access Video or Poster Abstract: MP54-12
Sources of Funding: none

Introduction

Sarcopenia, an objective measurement of frailty, has been associated with poor outcomes in lung, gastrointestinal, and breast cancers. We examined the relationship between sarcopenia and postoperative complications in patients undergoing radical cystectomy for bladder cancer.

Methods

151 patients who underwent radical cystectomy for high risk or muscle invasive bladder cancer were identified from a prospectively collected institutional database from November 2008 to April 2016. All patients had preoperative computed tomography imaging within 30 days of surgery for inclusion. Regions of interest (ROI) were drawn around the iliopsoas and erector spinae (ES) muscular compartments bilaterally, and the density was recorded as an average of measurements by a genitourinary radiologist blinded to postoperative outcome. Postoperative complications were identified as defined by the American College of Surgeons National Surgery Quality Improvement Program within a 90-day follow-up period.

Results

276 complications were identified in 114 patients (75.5%). Iliopsoas muscle density correlated moderately with ES muscle density (r² = 0.344, p <0.001) and both iliopsoas and ES density correlated with age (r² = 0.082, p <0.001 and r² = 0.165, p <0.001 respectively). While no overall association was found between iliopsoas muscle density and complications, lower ES density was associated with incidence of any complication (22.2 HU vs. 30.1 HU, p = 0.016) and an increased number of complications (r² = 0.032, p = 0.014). Lower iliopsoas muscle density was associated with increased incidence of wound infection (36.5 HU vs. 42.7 HU, p = 0.019), whereas lower ES density was associated with the need for reoperation (12.3 HU vs. 25.2 HU, p = 0.041)._x000D_

Conclusions

Sarcopenia is associated with a higher incidence of postoperative complications in patients undergoing radical cystectomy for bladder cancer. Preoperative iliopsoas density and a novel measure, ES density, may be helpful to identify those patients at greater risk of major post-operative complications.

Funding

none