Clinical Impact of Sarcopenia and Inflammatory/Nutritional Markers in Patients with Unresectable Metastatic Urothelial Carcinoma Treated with Pembrolizumab
Sarcopenia is a muscle loss syndrome known as a risk factor of various carcinomas. The impact of sarcopenia and sarcopenia-related inflammatory/nutritional markers in metastatic urothelial carcinoma (mUC) treated with pembrolizumab was unknown, so this retrospective study of 27 patients was performe...
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| Format: | Article |
| Language: | English |
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MDPI AG
2020-05-01
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| Series: | Diagnostics |
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| Online Access: | https://www.mdpi.com/2075-4418/10/5/310 |
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| author | Takuto Shimizu Makito Miyake Shunta Hori Kazuki Ichikawa Chihiro Omori Yusuke Iemura Takuya Owari Yoshitaka Itami Yasushi Nakai Satoshi Anai Atsushi Tomioka Nobumichi Tanaka Kiyohide Fujimoto |
| author_facet | Takuto Shimizu Makito Miyake Shunta Hori Kazuki Ichikawa Chihiro Omori Yusuke Iemura Takuya Owari Yoshitaka Itami Yasushi Nakai Satoshi Anai Atsushi Tomioka Nobumichi Tanaka Kiyohide Fujimoto |
| author_sort | Takuto Shimizu |
| collection | DOAJ |
| description | Sarcopenia is a muscle loss syndrome known as a risk factor of various carcinomas. The impact of sarcopenia and sarcopenia-related inflammatory/nutritional markers in metastatic urothelial carcinoma (mUC) treated with pembrolizumab was unknown, so this retrospective study of 27 patients was performed. Psoas muscle mass index (PMI) was calculated by bilateral psoas major muscle area at the L3 with computed tomography. The cut-off PMI value for sarcopenia was defined as ≤6.36 cm<sup>2</sup>/m<sup>2</sup> for men and ≤3.92 cm<sup>2</sup>/m<sup>2</sup> for women. Neutrophil-to-lymphocyte ratio (NLR) ≥ 4.0 and sarcopenia correlated with significantly shorter progression-free survival (PFS) (hazard ratio (HR) 3.81, <i>p</i> = 0.020; and HR 2.99, <i>p</i> = 0.027, respectively). Multivariate analyses identified NLR ≥ 4.0 and sarcopenia as independent predictors for PFS (HR 2.89, <i>p</i> = 0.025; and HR 2.79, <i>p</i> = 0.030, respectively). Prognostic nutrition index < 45, NLR ≥ 4.0 and sarcopenia were correlated with significantly worse for overall survival (OS) (HR 3.44, <i>p</i> = 0.046; HR 4.26, <i>p</i> = 0.024; and HR 3.92, <i>p</i> = 0.012, respectively). Multivariate analyses identified sarcopenia as an independent predictor for OS (HR 4.00, <i>p</i> = 0.026). Furthermore, a decrease in PMI ≥ 5% in a month was an independent predictor of PFS and OS (HR 12.8, <i>p</i> = 0.008; and HR 6.21, <i>p</i> = 0.036, respectively). Evaluation of sarcopenia and inflammatory/nutritional markers may help in the management of mUC with pembrolizumab. |
| first_indexed | 2024-03-10T19:47:46Z |
| format | Article |
| id | doaj.art-965726a99e084eafb01692f1bcba14c2 |
| institution | Directory Open Access Journal |
| issn | 2075-4418 |
| language | English |
| last_indexed | 2024-03-10T19:47:46Z |
| publishDate | 2020-05-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Diagnostics |
| spelling | doaj.art-965726a99e084eafb01692f1bcba14c22023-11-20T00:39:28ZengMDPI AGDiagnostics2075-44182020-05-0110531010.3390/diagnostics10050310Clinical Impact of Sarcopenia and Inflammatory/Nutritional Markers in Patients with Unresectable Metastatic Urothelial Carcinoma Treated with PembrolizumabTakuto Shimizu0Makito Miyake1Shunta Hori2Kazuki Ichikawa3Chihiro Omori4Yusuke Iemura5Takuya Owari6Yoshitaka Itami7Yasushi Nakai8Satoshi Anai9Atsushi Tomioka10Nobumichi Tanaka11Kiyohide Fujimoto12Department of Urology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, JapanDepartment of Urology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, JapanDepartment of Urology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, JapanDepartment of Urology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, JapanDepartment of Urology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, JapanDepartment of Urology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, JapanDepartment of Urology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, JapanDepartment of Urology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, JapanDepartment of Urology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, JapanDepartment of Urology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, JapanDepartment of Urology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, JapanDepartment of Urology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, JapanDepartment of Urology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, JapanSarcopenia is a muscle loss syndrome known as a risk factor of various carcinomas. The impact of sarcopenia and sarcopenia-related inflammatory/nutritional markers in metastatic urothelial carcinoma (mUC) treated with pembrolizumab was unknown, so this retrospective study of 27 patients was performed. Psoas muscle mass index (PMI) was calculated by bilateral psoas major muscle area at the L3 with computed tomography. The cut-off PMI value for sarcopenia was defined as ≤6.36 cm<sup>2</sup>/m<sup>2</sup> for men and ≤3.92 cm<sup>2</sup>/m<sup>2</sup> for women. Neutrophil-to-lymphocyte ratio (NLR) ≥ 4.0 and sarcopenia correlated with significantly shorter progression-free survival (PFS) (hazard ratio (HR) 3.81, <i>p</i> = 0.020; and HR 2.99, <i>p</i> = 0.027, respectively). Multivariate analyses identified NLR ≥ 4.0 and sarcopenia as independent predictors for PFS (HR 2.89, <i>p</i> = 0.025; and HR 2.79, <i>p</i> = 0.030, respectively). Prognostic nutrition index < 45, NLR ≥ 4.0 and sarcopenia were correlated with significantly worse for overall survival (OS) (HR 3.44, <i>p</i> = 0.046; HR 4.26, <i>p</i> = 0.024; and HR 3.92, <i>p</i> = 0.012, respectively). Multivariate analyses identified sarcopenia as an independent predictor for OS (HR 4.00, <i>p</i> = 0.026). Furthermore, a decrease in PMI ≥ 5% in a month was an independent predictor of PFS and OS (HR 12.8, <i>p</i> = 0.008; and HR 6.21, <i>p</i> = 0.036, respectively). Evaluation of sarcopenia and inflammatory/nutritional markers may help in the management of mUC with pembrolizumab.https://www.mdpi.com/2075-4418/10/5/310immune checkpoint inhibitorPembrolizumabSarcopeniapsoas muscle mass indexneutrophil-to-lymphocyte ratioprognostic nutritional index |
| spellingShingle | Takuto Shimizu Makito Miyake Shunta Hori Kazuki Ichikawa Chihiro Omori Yusuke Iemura Takuya Owari Yoshitaka Itami Yasushi Nakai Satoshi Anai Atsushi Tomioka Nobumichi Tanaka Kiyohide Fujimoto Clinical Impact of Sarcopenia and Inflammatory/Nutritional Markers in Patients with Unresectable Metastatic Urothelial Carcinoma Treated with Pembrolizumab Diagnostics immune checkpoint inhibitor Pembrolizumab Sarcopenia psoas muscle mass index neutrophil-to-lymphocyte ratio prognostic nutritional index |
| title | Clinical Impact of Sarcopenia and Inflammatory/Nutritional Markers in Patients with Unresectable Metastatic Urothelial Carcinoma Treated with Pembrolizumab |
| title_full | Clinical Impact of Sarcopenia and Inflammatory/Nutritional Markers in Patients with Unresectable Metastatic Urothelial Carcinoma Treated with Pembrolizumab |
| title_fullStr | Clinical Impact of Sarcopenia and Inflammatory/Nutritional Markers in Patients with Unresectable Metastatic Urothelial Carcinoma Treated with Pembrolizumab |
| title_full_unstemmed | Clinical Impact of Sarcopenia and Inflammatory/Nutritional Markers in Patients with Unresectable Metastatic Urothelial Carcinoma Treated with Pembrolizumab |
| title_short | Clinical Impact of Sarcopenia and Inflammatory/Nutritional Markers in Patients with Unresectable Metastatic Urothelial Carcinoma Treated with Pembrolizumab |
| title_sort | clinical impact of sarcopenia and inflammatory nutritional markers in patients with unresectable metastatic urothelial carcinoma treated with pembrolizumab |
| topic | immune checkpoint inhibitor Pembrolizumab Sarcopenia psoas muscle mass index neutrophil-to-lymphocyte ratio prognostic nutritional index |
| url | https://www.mdpi.com/2075-4418/10/5/310 |
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