Prognostic Effect of Preoperative Psoas Muscle Hounsfield Unit at Radical Cystectomy for Bladder Cancer

Radical cystectomy (RC) is the standard treatment for patients with advanced bladder cancer. Since RC is a highly invasive procedure, the surgical indications in an aging society must be carefully judged. In recent years, the concept of “frailty” has been attracting attention as a term used to descr...

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Autores principales:	Yusuke Sugino, Takeshi Sasaki, Manabu Kato, Satoru Masui, Kouhei Nishikawa, Takashi Okamoto, Shinya Kajiwara, Takuji Shibahara, Takehisa Onishi, Shiori Tanaka, Hideki Kanda, Hiroshi Matsuura, Takahiro Inoue
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	bladder cancer urothelial carcinoma radical cystectomy frailty prognostic factor psoas muscle Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
Acceso en línea:	https://doaj.org/article/95eb04d4468443bdb01f3af2321ee2d6
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spelling	oai:doaj.org-article:95eb04d4468443bdb01f3af2321ee2d62021-11-25T17:01:49ZPrognostic Effect of Preoperative Psoas Muscle Hounsfield Unit at Radical Cystectomy for Bladder Cancer10.3390/cancers132256292072-6694https://doaj.org/article/95eb04d4468443bdb01f3af2321ee2d62021-11-01T00:00:00Zhttps://www.mdpi.com/2072-6694/13/22/5629https://doaj.org/toc/2072-6694Radical cystectomy (RC) is the standard treatment for patients with advanced bladder cancer. Since RC is a highly invasive procedure, the surgical indications in an aging society must be carefully judged. In recent years, the concept of “frailty” has been attracting attention as a term used to describe fragility due to aging. We focused on the psoas muscle Hounsfield unit (PMHU) and analyzed its appropriateness as a prognostic factor together with other clinical factors in patients after RC. We retrospectively analyzed the preoperative prognostic factors in 177 patients with bladder cancer who underwent RC between 2008 and 2020. Preoperative non-contrast computed tomography axial image at the third lumbar vertebral level was used to measure the mean Hounsfield unit (HU) and cross-sectional area (mm<sup>2</sup>) of the psoas muscle. Univariate analysis showed significant differences in age, sex, clinical T stage, and PMHU. In multivariate analysis using the Cox proportional hazards model, age (hazard ratio (HR) = 1.734), sex (HR = 2.116), cT stage (HR = 1.665), and PMHU (HR = 1.758) were significant predictors for overall survival. Furthermore, using these four predictors, it was possible to stratify the prognosis of patients after RC. Finally, PMHU was useful as a simple and significant preoperative factor that correlated with prognosis after RC.Yusuke SuginoTakeshi SasakiManabu KatoSatoru MasuiKouhei NishikawaTakashi OkamotoShinya KajiwaraTakuji ShibaharaTakehisa OnishiShiori TanakaHideki KandaHiroshi MatsuuraTakahiro InoueMDPI AGarticlebladder cancerurothelial carcinomaradical cystectomyfrailtyprognostic factorpsoas muscleNeoplasms. Tumors. Oncology. Including cancer and carcinogensRC254-282ENCancers, Vol 13, Iss 5629, p 5629 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	bladder cancer urothelial carcinoma radical cystectomy frailty prognostic factor psoas muscle Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
spellingShingle	bladder cancer urothelial carcinoma radical cystectomy frailty prognostic factor psoas muscle Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 Yusuke Sugino Takeshi Sasaki Manabu Kato Satoru Masui Kouhei Nishikawa Takashi Okamoto Shinya Kajiwara Takuji Shibahara Takehisa Onishi Shiori Tanaka Hideki Kanda Hiroshi Matsuura Takahiro Inoue Prognostic Effect of Preoperative Psoas Muscle Hounsfield Unit at Radical Cystectomy for Bladder Cancer
description	Radical cystectomy (RC) is the standard treatment for patients with advanced bladder cancer. Since RC is a highly invasive procedure, the surgical indications in an aging society must be carefully judged. In recent years, the concept of “frailty” has been attracting attention as a term used to describe fragility due to aging. We focused on the psoas muscle Hounsfield unit (PMHU) and analyzed its appropriateness as a prognostic factor together with other clinical factors in patients after RC. We retrospectively analyzed the preoperative prognostic factors in 177 patients with bladder cancer who underwent RC between 2008 and 2020. Preoperative non-contrast computed tomography axial image at the third lumbar vertebral level was used to measure the mean Hounsfield unit (HU) and cross-sectional area (mm<sup>2</sup>) of the psoas muscle. Univariate analysis showed significant differences in age, sex, clinical T stage, and PMHU. In multivariate analysis using the Cox proportional hazards model, age (hazard ratio (HR) = 1.734), sex (HR = 2.116), cT stage (HR = 1.665), and PMHU (HR = 1.758) were significant predictors for overall survival. Furthermore, using these four predictors, it was possible to stratify the prognosis of patients after RC. Finally, PMHU was useful as a simple and significant preoperative factor that correlated with prognosis after RC.
format	article
author	Yusuke Sugino Takeshi Sasaki Manabu Kato Satoru Masui Kouhei Nishikawa Takashi Okamoto Shinya Kajiwara Takuji Shibahara Takehisa Onishi Shiori Tanaka Hideki Kanda Hiroshi Matsuura Takahiro Inoue
author_facet	Yusuke Sugino Takeshi Sasaki Manabu Kato Satoru Masui Kouhei Nishikawa Takashi Okamoto Shinya Kajiwara Takuji Shibahara Takehisa Onishi Shiori Tanaka Hideki Kanda Hiroshi Matsuura Takahiro Inoue
author_sort	Yusuke Sugino
title	Prognostic Effect of Preoperative Psoas Muscle Hounsfield Unit at Radical Cystectomy for Bladder Cancer
title_short	Prognostic Effect of Preoperative Psoas Muscle Hounsfield Unit at Radical Cystectomy for Bladder Cancer
title_full	Prognostic Effect of Preoperative Psoas Muscle Hounsfield Unit at Radical Cystectomy for Bladder Cancer
title_fullStr	Prognostic Effect of Preoperative Psoas Muscle Hounsfield Unit at Radical Cystectomy for Bladder Cancer
title_full_unstemmed	Prognostic Effect of Preoperative Psoas Muscle Hounsfield Unit at Radical Cystectomy for Bladder Cancer
title_sort	prognostic effect of preoperative psoas muscle hounsfield unit at radical cystectomy for bladder cancer
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/95eb04d4468443bdb01f3af2321ee2d6
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Prognostic Effect of Preoperative Psoas Muscle Hounsfield Unit at Radical Cystectomy for Bladder Cancer

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