Nutritional Status Impairment Due to Neoadjuvant Chemotherapy Predicts Post-Radical Cystectomy Complications.
Aged
Antineoplastic Agents
/ adverse effects
Antineoplastic Combined Chemotherapy Protocols
/ adverse effects
Cystectomy
Female
Humans
Male
Middle Aged
Neoadjuvant Therapy
/ adverse effects
Nutritional Status
/ drug effects
Postoperative Complications
Retrospective Studies
Urinary Bladder Neoplasms
/ drug therapy
complication
nutrition
radical cystectomy
sarcopenia
Journal
Nutrients
ISSN: 2072-6643
Titre abrégé: Nutrients
Pays: Switzerland
ID NLM: 101521595
Informations de publication
Date de publication:
14 Dec 2021
14 Dec 2021
Historique:
received:
10
11
2021
revised:
10
12
2021
accepted:
13
12
2021
entrez:
28
12
2021
pubmed:
29
12
2021
medline:
13
1
2022
Statut:
epublish
Résumé
Radical cystectomy (RC) is the standard treatment for muscle invasive bladder cancer (MIBC). Neoadjuvant chemotherapy (NAC) is associated with improved patient survival. The impact of NAC on nutritional status is understudied, while the association between malnutrition and poor surgical outcomes is well known. This study aims to examine the association between NAC, nutritional status impairment, and post-operative morbidity. We included MIBC patients who underwent RC and received NAC from multiple academic centers in Israel. Cross-sectional imaging was used to measure the psoas muscle area and normalized it by height (smooth muscle index, SMI). Pre- and post-NAC SMI difference was calculated (represents nutritional status change). The primary outcomes were post-RC ileus, infection, and a composite outcome of any complication. Logistic regression models were fit to identify independent predictors of the outcomes. Ninety-one patients were included in the study. The median SMI change was -0.71 (-1.58, -0.06) cm NAC-related nutritional deterioration is associated with increased risk of complications after RC. Our results hint towards the need for nutritional intervention during NAC prior to RC.
Sections du résumé
BACKGROUND
BACKGROUND
Radical cystectomy (RC) is the standard treatment for muscle invasive bladder cancer (MIBC). Neoadjuvant chemotherapy (NAC) is associated with improved patient survival. The impact of NAC on nutritional status is understudied, while the association between malnutrition and poor surgical outcomes is well known. This study aims to examine the association between NAC, nutritional status impairment, and post-operative morbidity.
MATERIALS AND METHODS
METHODS
We included MIBC patients who underwent RC and received NAC from multiple academic centers in Israel. Cross-sectional imaging was used to measure the psoas muscle area and normalized it by height (smooth muscle index, SMI). Pre- and post-NAC SMI difference was calculated (represents nutritional status change). The primary outcomes were post-RC ileus, infection, and a composite outcome of any complication. Logistic regression models were fit to identify independent predictors of the outcomes.
RESULTS
RESULTS
Ninety-one patients were included in the study. The median SMI change was -0.71 (-1.58, -0.06) cm
CONCLUSIONS
CONCLUSIONS
NAC-related nutritional deterioration is associated with increased risk of complications after RC. Our results hint towards the need for nutritional intervention during NAC prior to RC.
Identifiants
pubmed: 34960023
pii: nu13124471
doi: 10.3390/nu13124471
pmc: PMC8708207
pii:
doi:
Substances chimiques
Antineoplastic Agents
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
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