Abstract: PD36-04
Sources of Funding: None

Introduction

Sarcopenia, defined as decreased muscle mass, has proven to be an easily accessible and accurate indication of frailty in the elderly population. It has been shown to predict cancer-specific and overall survival in patients undergoing radical cystectomy for urothelial carcinoma of the bladder. However, no studies have reported the impact of sarcopenia on the toxicity of chemotherapy and prognosis of patients treated with adjuvant chemotherapy. The aim of our study was to compare survival outcomes of sarcopenic and non-sarcopenic patients who are undergoing adjuvant chemotherapy after having undergone radical cystectomy.

Methods

We performed a retrospective cohort analysis of all patients who underwent radical cystectomy between 2005 and 2012 for high-risk superficial or muscle-invasive urothelial or undifferentiated bladder cancer who also underwent adjuvant chemotherapy for disease found to be metastatic or locally advanced at the time of surgery. Cohorts were separated on the basis of sarcopenia, defined as a normalized Total Psoas Area (TPA) of less than 8 cm2/m2 on CT. Overall survival was estimated using the Kaplan-Meier method and compared with the log-rank test.

Results

A total of 56 patients were identified for this study. 14 of the 56 patients (25%) who underwent adjuvant cisplatin-based chemotherapy were determined to be sarcopenic. Overall survival after the start of adjuvant therapy for sarcopenic patients was 25.12 months, as compared to non-sarcopenic patients who demonstrated an overall survival of 44.30 months (p<0.05). The 5-year survival rates were 21% and 36% for the two groups, respectively. While the time to local and distant recurrences was greater in the non-sarcopenic patients, as compared to those with sarcopenia, there was no statistically significant difference.

Conclusions

Our analysis has indicated that patients with sarcopenia have a worse overall survival when treated with adjuvant chemotherapy after radical cystectomy. In order to conclude whether sarcopenic patients should be receiving adjuvant therapy, future studies must match these patients with sarcopenic patients who met criteria to receive adjuvant chemotherapy after radical cystectomy, yet decided to forego treatment._x000D_ _x000D_

Funding

None