Sarcopenia as a prognostic biomarker of advanced urothelial carcinoma.
<h4>Objectives</h4>Sarcopenia, a novel concept reflecting the degenerative loss of skeletal muscle mass, is an objective indicator of cancer cachexia. We investigated its role as a prognostic biomarker in advanced urothelial carcinoma (UC) patients.<h4>Methods</h4>This retros...
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doaj-ac666c677420493f806aa0a133c4cc5b2021-03-04T08:37:03ZengPublic Library of Science (PLoS)PLoS ONE1932-62032015-01-01101e011589510.1371/journal.pone.0115895Sarcopenia as a prognostic biomarker of advanced urothelial carcinoma.Hiroshi FukushimaMinato YokoyamaYasukazu NakanishiKen-ichi TobisuFumitaka Koga<h4>Objectives</h4>Sarcopenia, a novel concept reflecting the degenerative loss of skeletal muscle mass, is an objective indicator of cancer cachexia. We investigated its role as a prognostic biomarker in advanced urothelial carcinoma (UC) patients.<h4>Methods</h4>This retrospective study consisted of 88 UC patients with cT4 and/or metastases to lymph nodes/distant organs. Skeletal muscle index (SMI), an indicator of whole-body muscle mass, was measured from computed tomography (CT) images at the diagnosis. Sarcopenia was defined as SMIs of <43 cm(2)/m(2) for males with body mass index (BMI) <25 cm(2)/m(2), <53 cm(2)/m(2) for males with BMI ≥ 25 cm(2)/m(2), and <41 cm(2)/m(2) for females. Predictors of overall survival (OS) were examined using Cox proportional hazard models.<h4>Results</h4>Sixty-seven patients (76%) died during the median follow-up of 13 months. The median OS rate was 13 months. Multivariate analysis revealed that SMI was a significant and independent predictor of shorter OS (hazard ratio (HR) 0.90, P <0.001). In the present cohort, 53 (60%) were diagnosed with sarcopenia. The median OS rates were 11 and 31 months for sarcopenic and non-sarcopenic patients, respectively (P <0.001). On multivariate analysis, sarcopenia was a significant and independent predictor of shorter OS (HR 3.36, P <0.001), along with higher C-reactive protein (CRP) (P = 0.001), upper urinary tract cancer (P = 0.007), higher lactate dehydrogenase (LDH) (P = 0.047), and higher alkaline phosphatase (ALP) (P = 0.048).<h4>Conclusion</h4>Sarcopenia, which is readily evaluated on routine CT scans, is a useful prognostic biomarker of advanced UC. Non-sarcopenic patients can expect long-term survival. Evaluating sarcopenia can be helpful for decision-making processes in the management of advanced UC patients.https://doi.org/10.1371/journal.pone.0115895 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Hiroshi Fukushima Minato Yokoyama Yasukazu Nakanishi Ken-ichi Tobisu Fumitaka Koga |
spellingShingle |
Hiroshi Fukushima Minato Yokoyama Yasukazu Nakanishi Ken-ichi Tobisu Fumitaka Koga Sarcopenia as a prognostic biomarker of advanced urothelial carcinoma. PLoS ONE |
author_facet |
Hiroshi Fukushima Minato Yokoyama Yasukazu Nakanishi Ken-ichi Tobisu Fumitaka Koga |
author_sort |
Hiroshi Fukushima |
title |
Sarcopenia as a prognostic biomarker of advanced urothelial carcinoma. |
title_short |
Sarcopenia as a prognostic biomarker of advanced urothelial carcinoma. |
title_full |
Sarcopenia as a prognostic biomarker of advanced urothelial carcinoma. |
title_fullStr |
Sarcopenia as a prognostic biomarker of advanced urothelial carcinoma. |
title_full_unstemmed |
Sarcopenia as a prognostic biomarker of advanced urothelial carcinoma. |
title_sort |
sarcopenia as a prognostic biomarker of advanced urothelial carcinoma. |
publisher |
Public Library of Science (PLoS) |
series |
PLoS ONE |
issn |
1932-6203 |
publishDate |
2015-01-01 |
description |
<h4>Objectives</h4>Sarcopenia, a novel concept reflecting the degenerative loss of skeletal muscle mass, is an objective indicator of cancer cachexia. We investigated its role as a prognostic biomarker in advanced urothelial carcinoma (UC) patients.<h4>Methods</h4>This retrospective study consisted of 88 UC patients with cT4 and/or metastases to lymph nodes/distant organs. Skeletal muscle index (SMI), an indicator of whole-body muscle mass, was measured from computed tomography (CT) images at the diagnosis. Sarcopenia was defined as SMIs of <43 cm(2)/m(2) for males with body mass index (BMI) <25 cm(2)/m(2), <53 cm(2)/m(2) for males with BMI ≥ 25 cm(2)/m(2), and <41 cm(2)/m(2) for females. Predictors of overall survival (OS) were examined using Cox proportional hazard models.<h4>Results</h4>Sixty-seven patients (76%) died during the median follow-up of 13 months. The median OS rate was 13 months. Multivariate analysis revealed that SMI was a significant and independent predictor of shorter OS (hazard ratio (HR) 0.90, P <0.001). In the present cohort, 53 (60%) were diagnosed with sarcopenia. The median OS rates were 11 and 31 months for sarcopenic and non-sarcopenic patients, respectively (P <0.001). On multivariate analysis, sarcopenia was a significant and independent predictor of shorter OS (HR 3.36, P <0.001), along with higher C-reactive protein (CRP) (P = 0.001), upper urinary tract cancer (P = 0.007), higher lactate dehydrogenase (LDH) (P = 0.047), and higher alkaline phosphatase (ALP) (P = 0.048).<h4>Conclusion</h4>Sarcopenia, which is readily evaluated on routine CT scans, is a useful prognostic biomarker of advanced UC. Non-sarcopenic patients can expect long-term survival. Evaluating sarcopenia can be helpful for decision-making processes in the management of advanced UC patients. |
url |
https://doi.org/10.1371/journal.pone.0115895 |
work_keys_str_mv |
AT hiroshifukushima sarcopeniaasaprognosticbiomarkerofadvancedurothelialcarcinoma AT minatoyokoyama sarcopeniaasaprognosticbiomarkerofadvancedurothelialcarcinoma AT yasukazunakanishi sarcopeniaasaprognosticbiomarkerofadvancedurothelialcarcinoma AT kenichitobisu sarcopeniaasaprognosticbiomarkerofadvancedurothelialcarcinoma AT fumitakakoga sarcopeniaasaprognosticbiomarkerofadvancedurothelialcarcinoma |
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