MP08-11: Body composition can predict oncological outcome in non-muscle invasive bladder cancer patients who receive intravesical instillation with Bacillus Calmette-Guerin after transurethral resection of bladder tumor
Introduction: Review of previous literature showed still conflicted opinions on influence of obesity in bladder cancer (BC) prognosis, while high body mass index(BMI) being an independent risk factor of BC. This study was aimed to find out the impact of body composition, including sarcopenia and obesity, on the oncological prognosis of non-muscle invasive bladder cancer (NMIBC) patients receiving transurethral resection of bladder tumor (TURBT) with adjuvant intravesical instillation (IVI) with Bacillus Calmette-Guerin (BCG). Methods: We retrospectively recruited patients with NMIBC who had received TURBT with adjuvant IVI with BCG from March 2005 to April 2021. Body composition parameters were evaluated according to analysis of computed tomography (CT) L3 images with artificial intelligence (AI) models and BMI, and was further categorized into sarcopenia and obesity groups. Oncological outcomes including recurrence-free survival (RFS), progression-free survival (PFS) and overall survival (OS) after treatment of TURBT with adjuvant IVI with BCG were analyzed using uni- and multivariate analysis. Impact of sarcopenia and obesity was analyzed with Kaplan-Meier survival exam. Results: Total of 269 patients were enrolled. All patients were diagnosed with NMIBC and majority were Ta or T1, accounting for 44.6% and 50.9% respectively. Among them, 80 patients were sarcopenic and 53 were obese, accounting for 29.7% and 19.7% respectively. Subcutaneous adipose tissue density on CT was a significant predictor for RFS (p=0.011) and psoas muscle density also had significant impact on OS (p=0.044) in multivariate analysis. Sarcopenic or non-obese patients endured significantly fewer BCG IVI than non-sarcopenic or obese patients. Patients with sarcopenia had poorer RFS (p=0.030) and OS (p=0.033). In contrast, obese patients had better OS (p=0.008). Conclusions: In our study, we first demonstrated that body composition, sarcopenia, and obesity had significant impact on the RFS, PFS and OS in NMIBC patients. Non-sarcopenic and obese patients can significantly endure more BCG IVI and thus may result in superior oncological outcome. In patients with NMIBC, obese group had better OS while sarcopenic patients had worse OS and RFS. Body composition measurements has potentials in assessments of oncological outcomes of NMIBC patients. SOURCE OF Funding: No source of funding
