Changes in Lean Muscle Mass Associated with Neoadjuvant Platinum-Based Chemotherapy in Patients with Muscle Invasive Bladder Cancer

Title	Changes in Lean Muscle Mass Associated with Neoadjuvant Platinum-Based Chemotherapy in Patients with Muscle Invasive Bladder Cancer
Authors	Kalen J. Rimar, Alexander P. Glaser, Shilajit Kundu, Edward M. Schaeffer, Joshua Meeks, Sarah P. Psutka
Magazine	Bladder Cancer (Amsterdam, Netherlands)
Date	10/29/2018
DOI	10.3233/BLC-180188
Introduction	Baseline sarcopenia or severe lean muscle deficiency is independently linked to higher mortality after cystectomy for muscle-invasive urothelial carcinoma of the bladder (MIUC). The effect of chemotherapy on muscle mass in MIUC patients is not well defined. This study aims to detail preoperative body composition changes in MIUC patients undergoing platinum-based neoadjuvant chemotherapy (NC). Patients with cT2-4 N0-1 M0 UC of the bladder who received NC were identified. The lumbar skeletal muscle index (SMI), visceral adipose index (VAI), and subcutaneous and intramuscular adipose index (SAI) were calculated from pre- and post-NC computed tomography. Patients were classified as sarcopenic by consensus definitions: Male: SMI <55 cm²/m², Female: SMI <38.5 cm²/m². The median pre- and post-NC BMI, SMI, and adipose indices were compared. The study cohort consisted of 26 patients with a median age of 70 years, including 7 females (27%). Chemotherapy regimens included methotrexate, vinblastine, doxorubicin, and cisplatin (31%), gemcitabine/cisplatin (62%), and gemcitabine/carboplatin (3.8%) with a median of 3.5 cycles. Median pre- and post-NC BMI were 27.1 kg/m² and 27.2 kg/m², respectively. Median pre- and post-NC SMI were 49.1 cm²/m² and 44.5 cm²/m², respectively, with a significant decrease in lean muscle mass observed. The prevalence of sarcopenia increased from 69% pre-NC to 81% post-NC. The median time between chemotherapy initiation and cystectomy was 110 days. Pre-habilitative interventions may benefit patients to mitigate muscle loss before cystectomy.
Quote	Kalen J Rimar, Alexander P Glaser and Shilajit D. Kundu et al. Changes in Lean Muscle Mass Associated with Neoadjuvant Platinum-Based Chemotherapy in Patients with Muscle Invasive Bladder Cancer. 2018. DOI: 10.3233/BLC-180188
Element	Platinum (Pt)
Industry	Pharmaceutical Industry