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Skeletal Muscle Mass Reduction Velocity as a Simple Prognostic Indicator for Patients with Metastatic Urothelial Carcinoma Receiving Second-Line Chemotherapy
- Source :
- Asian Pacific Journal of Cancer Prevention : APJCP
- Publication Year :
- 2019
- Publisher :
- West Asia Organization for Cancer Prevention, 2019.
-
Abstract
- Background: Patients with metastatic urothelial carcinoma (mUC) have an uncertain prognosis. The aim of the current study was to evaluate the prognostic potential of a skeletal muscle mass reduction index measured by computed tomography (CT) for mUC patients undergoing second-line gemcitabine and docetaxel (GD) chemotherapy. Methods: We retrospectively reviewed 44 patients with mUC who received second-line GD chemotherapy between 2006 and 2015 in our hospital. Skeletal muscle area (SMA) at the third lumbar vertebra was measured using CT images obtained from medical records, and a skeletal muscle index (SMI) was calculated for each patient as: SMI = SMA / height2. Changes in SMI across timepoints (SMI inclination) were calculated as: SMI inclination = [( SMI/SMI)/duration of the interval between imaging visits]. Patients were then divided into two groups: a “steep” group (SMI inclination < -0.01) and a “gentle” group (SMI inclination ≥ -0.01). Kaplan-Meier curves and multivariate Cox proportional hazards regression models were used to evaluate the relationship between SMI inclination and overall survival (OS). Results: There were no differences in patient characteristics between the two groups with respect to median age, gender, Eastern Cooperative Oncology Group Performance Status (ECOG-PS), disease control rate or first-line treatment regimen. OS from the start of second-line GD therapy group was significantly shorter in the “steep” group relative to the “gentle” group. The multivariate analysis revealed that “steep” SMI inclination and presence of anemia were strong predictors of poor prognosis. Conclusion: Higher values of SMI inclination, indicating a faster rate of skeletal muscle mass reduction, may serve as a useful predictive marker for OS in mUC patients undergoing second-line GD chemotherapy.
- Subjects :
- 0301 basic medicine
Adult
Male
medicine.medical_specialty
Sarcopenia
Urologic Neoplasms
Metastatic Urothelial Carcinoma
Anemia
medicine.medical_treatment
education
Urology
Docetaxel
Deoxycytidine
03 medical and health sciences
0302 clinical medicine
mental disorders
Antineoplastic Combined Chemotherapy Protocols
medicine
Humans
prognostic factor
Muscle, Skeletal
Aged
Retrospective Studies
Aged, 80 and over
Chemotherapy
Carcinoma, Transitional Cell
Predictive marker
second-line chemotherapy
business.industry
fungi
Skeletal muscle
General Medicine
Middle Aged
medicine.disease
Prognosis
Gemcitabine
Survival Rate
030104 developmental biology
medicine.anatomical_structure
030220 oncology & carcinogenesis
Female
business
medicine.drug
Research Article
Follow-Up Studies
Subjects
Details
- Language :
- English
- ISSN :
- 2476762X and 15137368
- Volume :
- 20
- Issue :
- 10
- Database :
- OpenAIRE
- Journal :
- Asian Pacific Journal of Cancer Prevention : APJCP
- Accession number :
- edsair.doi.dedup.....7c568f05d638291626189e694acfefb9