Can sarcopenia predict outcomes in bladder cancer patients treated with chemoradiotherapy?
Corden, Michael Chin, S. Cree, Anthea Hoskin, Peter J McWilliam, Alan Satiti, A. D. Song, Yee Pei Green, Andrew Choudhury, Ananya
Corden, Michael
Chin, S.
Cree, Anthea
Hoskin, Peter J
McWilliam, Alan
Satiti, A. D.
Song, Yee Pei
Green, Andrew
Choudhury, Ananya
Citations
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Abstract
Purpose or Objective
Bladder cancer is the tenth commonest malignancy in the
UK, with approximately 10,200 new diagnoses and 5,400
deaths annually. Sarcopenia shows promise as a prognostic
factor for bladder cancer and has been shown to predict
overall survival (OS) in patients treated with radical
cystectomy. The present study aims to assess sarcopenia
as a predictor of OS and progression-free survival (PFS) in
patients with urothelial carcinoma (UC) of the bladder
treated with organ-sparing concurrent gemcitabine and
radiotherapy (GemX).
Material and Methods
244 patients with non-metastatic UC, treated from 2010-
2017 with 52.5Gy in 20 fractions of curative intent
radiotherapy with weekly gemcitabine, were identified for
analysis. Pre-treatment computed tomography (CT) scans
were obtained for 185 patients. The L3 vertebra was
identified manually and machine learning software was
used to assist skeletal muscle segmentation. Crosssectional
area of skeletal muscle was obtained and
normalised to patients’ height. This provided skeletal
muscle index (SMI). Sarcopenia was defined using sexspecific
international consensus SMI definitions of <39
cm²/m² in women and <55 cm²/m² in men. Associations
between pre-treatment sarcopenia and OS and PFS were
analysed using univariate and multivariate Cox
proportional hazards models and Kaplan-Meier (KM)
curves.
Results
Of 244 patients, 114 (46.7%) were sarcopenic, 71 (29.1%)
were non-sarcopenic and 59 (24.2%) had unknown SMI as
CT scans were not available. Sarcopenic patients tended
to be male (85.1% vs 61.1% in non-sarcopenic patients). No
significant differences were observed with respect to age,
T stage, smoker status, presence of carcinoma in situ,
albumin, haemoglobin, adult comorbidity evaluation-27,
World Health Organisation Performance Status (WHO PS),
hydronephrosis, neutrophil count, lymphocyte count,
tumour stage and provision of neoadjuvant chemotherapy.
Median OS and PFS were 40 (interquartile range [IQR] 23.8
– 62) and 32 (IQR 14 - 54.3) months respectively (see figure
1). Univariate analysis showed no association between
sarcopenia and OS or PFS. On multivariate analysis, WHO
PS, hydronephrosis and neutrophil count were associated with worse OS and PFS. Conclusion
Sarcopenia is not associated with worse OS or PFS in
bladder cancer patients treated with concurrent
chemoradiotherapy.
Description
Date
2020
Publisher
Collections
Keywords
Type
Meetings and Proceedings
Citation
Corden M, Chin S, Cree A, Hoskin P, McWilliam A, Satiti AD, et al. PO-1216: Can sarcopenia predict outcomes in bladder cancer patients treated with chemoradiotherapy? Radiotherapy and Oncology . 2020 Nov;152:S640.