Pd34-06 Changes in Body Composition Following Neoadjuvant Chemotherapy for Patients Undergoing Radical Cystectomy

You have accessJournal of UrologyBladder Cancer: Invasive III (PD34)1 May 2024PD34-06 CHANGES IN BODY COMPOSITION FOLLOWING NEOADJUVANT CHEMOTHERAPY FOR PATIENTS UNDERGOING RADICAL CYSTECTOMY Ekamjit S. Deol, Grant Henning, Spyridon Basourakos, Anthony E. Fadel, Abhinav Khanna, Matthew K. Tollefson, Robert Tarrell, Prabin Thapa, R. Houston Thompson, Robert J. Karnes, Boyd R. Viers, Stephen A. Boorjian, Igor Frank, and Vidit Sharma Ekamjit S. DeolEkamjit S. Deol , Grant HenningGrant Henning , Spyridon BasourakosSpyridon Basourakos , Anthony E. FadelAnthony E. Fadel , Abhinav KhannaAbhinav Khanna , Matthew K. TollefsonMatthew K. Tollefson , Robert TarrellRobert Tarrell , Prabin ThapaPrabin Thapa , R. Houston ThompsonR. Houston Thompson , Robert J. KarnesRobert J. Karnes , Boyd R. ViersBoyd R. Viers , Stephen A. BoorjianStephen A. Boorjian , Igor FrankIgor Frank , and Vidit SharmaVidit Sharma View All Author Informationhttps://doi.org/10.1097/01.JU.0001008768.36634.79.06AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Although neoadjuvant chemotherapy (NAC) is standard of care for patients with bladder cancer undergoing radical cystectomy (RC), there can be substantial associated toxicities. We sought to characterize the impact of NAC on body composition parameters and post-op complication rates. METHODS: Our institutional cystectomy registry was queried for patients undergoing RC between 2000-2020 to identify a subset receiving NAC. This cohort was matched based on age, gender, and clinical stage to those receiving upfront RC. CT images obtained during the pre-op and post-op period were analyzed using a validated deep-learning algorithm for defining skeletal muscle and adipose areas at the L3 level. Our primary objective was to characterize changes in body composition measures over time. We additionally used logistic regression to determine associations between 90-day post-op complications and body composition metrics including sarcopenic obesity and visceral to subcutaneous fat ratio (VF:SQF ratio). RESULTS: 259 patients receiving NAC prior to RC were identified, of whom 187 (72.2%) received GC, 41 (15.8%) MVAC, and 31 (12.0%) any other regimen. 358 patients undergoing upfront RC were identified as a control cohort. Although a median Skeletal Muscle Index (SMI) of 52 cm2 was noted prior to treatment, patients receiving NAC had a significant decline in SMI (Figure 1) and no difference in SMI was seen at the time of RC compared to the control cohort (49.4 cm2 vs. 50.7 cm2, p=0.42). VF:SQF ratio remained stable during NAC (pre-NAC: 0.96 to post-NAC: 0.96, p=0.62), and there was no significant difference in VF:SQF at time of RC between NAC and control cohorts (0.96 vs 0.99, p=0.18). On regression analysis, pre-op sarcopenic obesity (OR: 1.71, p=0.03) and VF:SQF ratio (OR: 1.40, p=0.01) were significantly associated with major complications. There was no significant interaction between the use of neoadjuvant chemotherapy and presence of sarcopenic obesity or VF:SQF ratio. CONCLUSIONS: NAC is associated with significant declines in SMI and progression to sarcopenic obesity prior to RC. Presence of sarcopenic obesity, and high VF:SQF ratio were associated with increased surgical complications. These results highlight the utility of AI-derived body composition measures in individualizing pre-op patient counselling. Download PPT Source of Funding: Thomas P. and Elizabeth S. Grainger Urology Fellowship Fund © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e720 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Ekamjit S. Deol More articles by this author Grant Henning More articles by this author Spyridon Basourakos More articles by this author Anthony E. Fadel More articles by this author Abhinav Khanna More articles by this author Matthew K. Tollefson More articles by this author Robert Tarrell More articles by this author Prabin Thapa More articles by this author R. Houston Thompson More articles by this author Robert J. Karnes More articles by this author Boyd R. Viers More articles by this author Stephen A. Boorjian More articles by this author Igor Frank More articles by this author Vidit Sharma More articles by this author Expand All Advertisement PDF downloadLoading ...