Curative Radiotherapy in Elderly Patients With Muscle Invasive Bladder Cancer: The Prognostic Role of Sarcopenia.
BACKGROUND/AIM
To evaluate the impact of sarcopenia in muscle invasive bladder cancer (MIBC) elderly patients submitted to curative radiotherapy.


PATIENTS AND METHODS
Patients received radiotherapy between 2013 and 2018, and the skeletal muscle index was calculated to classify them as sarcopenic or non-sarcopenic. Primary endpoints were overall survival (OS), cancer specific survival (CSS), 90-day mortality and toxicity.


RESULTS
A total of 28 patients with a median age of 85 years met our inclusion criteria and 8 of them were sarcopenic. With a median prescribed dose of 61 Gy and a median follow-up of 24.5 months, OS rates in the sarcopenic and non-sarcopenic groups were 100% and 84.4% at 3 months, 57.1% and 56.6% at 12 months, 38.1% and 50.3% at 24 months and 38.1% and 33.5% at 48 months, respectively; the CSS rates were 100% and 94.1% at 3 months and 68.6% and 88.2% at 12, 24 and 48 months, respectively. The actuarial 90-day mortality rate was 17.9% for the whole cohort, and 20% and 12.5% for the non-sarcopenic and sarcopenic groups, respectively. The radio-induced toxicity was similar in both groups.


CONCLUSION
Sarcopenia cannot be considered a negative prognostic factor for MIBC elderly patients treated with external beam radiotherapy. Irradiation is therefore a feasible and effective choice for these patients, especially if unfit for surgery.
['Ferini|Gianluca|G|', 'Cacciola|Alberto|A|', 'Parisi|Silvana|S|', 'Lillo|Sara|S|', 'Molino|Laura|L|', 'Tamburella|Consuelo|C|', 'Davi|Valerio|V|', 'Napoli|Ilenia|I|', 'Platania|Angelo|A|', 'Settineri|Nicola|N|', 'Iati|Giuseppe|G|', 'Pontoriero|Antonio|A|', 'Pergolizzi|Stefano|S|', 'Santacaterina|Anna|A|']
D000368:Aged D000369:Aged, 80 and over D006801:Humans D018482:Muscle, Skeletal D011379:Prognosis D012189:Retrospective Studies D055948:Sarcopenia D015996:Survival Rate D001749:Urinary Bladder Neoplasms
Radiotherapy elderly bladder cancer sarcopenia