Clinical Impact of Sarcopenia and Inflammatory/Nutritional Markers in Patients with Unresectable Metastatic Urothelial Carcinoma Treated with Pembrolizumab

被引：47

作者：

Shimizu, Takuto ^{[1
,2
]}

Miyake, Makito ^{[1
]}

Hori, Shunta ^{[1
]}

Ichikawa, Kazuki ^{[1
]}

Omori, Chihiro ^{[1
]}

Iemura, Yusuke ^{[1
,2
]}

Owari, Takuya ^{[1
]}

Itami, Yoshitaka ^{[1
]}

Nakai, Yasushi ^{[1
]}

Anai, Satoshi ^{[1
]}

Tomioka, Atsushi ^{[1
,2
]}

Tanaka, Nobumichi ^{[1
]}

Fujimoto, Kiyohide ^{[1
]}

机构：

[1] Nara Med Univ, Dept Urol, 840 Shijo Cho, Kashihara, Nara 6348522, Japan

[2] Saiseikai Chuwa Hosp, Dept Urol, 323 Ooazaabe, Sakurai, Nara 6330054, Japan

来源：

DIAGNOSTICS | 2020年 / 10卷 / 05期

关键词：

immune checkpoint inhibitor; Pembrolizumab; Sarcopenia; psoas muscle mass index; neutrophil-to-lymphocyte ratio; prognostic nutritional index; urothelial carcinoma; prognosis; SOLID TUMORS; LYMPHOCYTE RATIO; PROGNOSTIC MARKERS; MUSCLE MASS; OPEN-LABEL; NIVOLUMAB; CANCER; INFLAMMATION; MULTICENTER; TOXICITY;

D O I：

10.3390/diagnostics10050310

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

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(2)/m(2) for men and <= 3.92 cm(2)/m(2) for women. Neutrophil-to-lymphocyte ratio (NLR) >= 4.0 and sarcopenia correlated with significantly shorter progression-free survival (PFS) (hazard ratio (HR) 3.81, p = 0.020; and HR 2.99, p = 0.027, respectively). Multivariate analyses identified NLR >= 4.0 and sarcopenia as independent predictors for PFS (HR 2.89, p = 0.025; and HR 2.79, p = 0.030, respectively). Prognostic nutrition index < 45, NLR >= 4.0 and sarcopenia were correlated with significantly worse for overall survival (OS) (HR 3.44, p = 0.046; HR 4.26, p = 0.024; and HR 3.92, p = 0.012, respectively). Multivariate analyses identified sarcopenia as an independent predictor for OS (HR 4.00, p = 0.026). Furthermore, a decrease in PMI >= 5% in a month was an independent predictor of PFS and OS (HR 12.8, p = 0.008; and HR 6.21, p = 0.036, respectively). Evaluation of sarcopenia and inflammatory/nutritional markers may help in the management of mUC with pembrolizumab.

引用

页数：16