Sarcopenia Is An Independent Predictor Of Survival Outcomes For Patients With Upper Tract Urothelial Carcinoma

Purpose: We evaluated the association between sarcopenia (loss of skeletal muscle mass) and overall survival, disease-free survival and cancer-specific survival in patients with upper tract urothelial carcinoma treated with radical nephroureterectomy. Materials and methods: From March 2005 to August 2015, we conducted a retrospective study of patients with upper tract urothelial carcinoma who underwent radical nephroureterectomy. Sarcopenia was assessed by the third lumbar vertebra skeletal muscle index (L3 SMI), and diagnosed by cut-off values obtained using the method of optimum stratification. Univariate and multivariate analyses were performed to evaluate risk factors for long-term survival. Results: A total of 227 patients were included in this study, and 68 (30%) patients were diagnosed with sarcopenia based on the cut-off values (38.95 cm(2)/m(2) for men and 34.55 cm(2)/m(2) for women). Multivariate analysis identified sarcopenia as an independent risk factor for overall survival (HR=2.955, P < 0.001), progression-free survival (HR=2.362, P=0.001) and cancer-specific survival (HR=2.279, P=0.002). Conclusions: The presence of sarcopenia is independently associated with poor overall survival, progression-free survival and cancer-specific survival after radical nephroureterectomy for upper tract urothelial carcinoma.