1626 Sarcopenia Predicts Post-Operative Complications and Length of Stay Following Radical Cystectomy

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You have accessJournal of UrologyBladder Cancer: Invasive (II)1 Apr 20131626 SARCOPENIA PREDICTS POST-OPERATIVE COMPLICATIONS AND LENGTH OF STAY FOLLOWING RADICAL CYSTECTOMY Janine Oliver, Goutham Vemana, Joel Vetter, Seth Strope, Christine Menias, Tanya Wildes, and Robert Grubb Janine OliverJanine Oliver Saint Louis, MO , Goutham VemanaGoutham Vemana Saint Louis, MO , Joel VetterJoel Vetter Saint Louis, MO , Seth StropeSeth Strope Saint Louis, MO , Christine MeniasChristine Menias Saint Louis, MO , Tanya WildesTanya Wildes Saint Louis, MO , and Robert GrubbRobert Grubb Saint Louis, MO View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.3176AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Sarcopenia, or loss of skeletal muscle mass, is a measure of frailty and physiological reserve and is quantified with morphometric measurement of skeletal muscle on cross-sectional imaging. Sarcopenia correlates with surgical and oncologic outcomes in many malignancies. However, the influence of sarcopenia on outcomes in patients undergoing radical cystectomy (RC) remains unexplored. METHODS Sarcopenia assessments were available on 79 of the 127 patients undergoing RC for urothelial cancer between January 2011 and August 2012 at Barnes-Jewish Hospital. We used preoperative computed tomographic (CT) images to calculate average psoas muscle area (PMA) by measuring the average area of the right and left psoas muscles at the level of the L3 vertebra. PMA was normalized for patient stature using body surface area. Patients were divided into tertiles of PMA with the high PMA group serving as the reference group for analysis. Outcomes assessed were length of stay (LOS), readmission and complications within 90 days of surgery. Complications were graded using the Clavien system and those with a grade ≥ 3 were classified as major complications. RESULTS 63 patients (79.7%) were male and 16 patients (20.3%) were female. Median age was 69 years old (41-83). Median PMA was 4.36 cm2/m2 (1.62-7.96). On univariate analysis, both overall and major complication rates were significantly higher in the low PMA group compared to the high PMA group (OR 7.06 (1.37-36.40) and OR 4.93 (1.33-18.31), respectively). LOS was also significantly longer in the low PMA group (p = 0.002). There was no difference in readmission rates. CONCLUSIONS Sarcopenia, as measured by psoas muscle area, is an easily obtained, objective measure of frailty. In a cohort of patients undergoing radical cystectomy, sarcopenia was associated with longer LOS and greater 90-day complication rates. Further studies in a larger cohort of patients will explore the use of sarcopenia as a measure of frailty to assist in pre-operative risk assessment and counseling prior to radical cystectomy. © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e668-e669 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.MetricsAuthor Information Janine Oliver Saint Louis, MO More articles by this author Goutham Vemana Saint Louis, MO More articles by this author Joel Vetter Saint Louis, MO More articles by this author Seth Strope Saint Louis, MO More articles by this author Christine Menias Saint Louis, MO More articles by this author Tanya Wildes Saint Louis, MO More articles by this author Robert Grubb Saint Louis, MO More articles by this author Expand All Advertisement Advertisement PDF DownloadLoading ...