Sarcopenia as a significant predictive factor of neutropenia and overall survival in urothelial carcinoma patients underwent gemcitabine and cisplatin or carboplatin

  • Tetsuya Yumioka
  • Masashi HondaEmail author
  • Ryoma Nishikawa
  • Shogo Teraoka
  • Yusuke Kimura
  • Hideto Iwamoto
  • Shuichi Morizane
  • Katsuya Hikita
  • Atsushi Takenaka
Original Article



To evaluate the relationship between sarcopenia and myelosuppression or between sarcopenia and survival outcomes in patients with urothelial carcinoma (UC) undergoing chemotherapy with gemcitabine plus cisplatin (GC) or carboplatin (GCa).


We evaluated 80 patients with UC who underwent chemotherapy between 2013 and 2017 at our institution. In total, 53 patients had metastatic UC and were ultimately included in the study. Predictive factors for myelosuppression (neutropenia, thrombocytopenia, and anemia) in all patients and overall survival (OS) in metastatic UC patients were analyzed. Sarcopenia was assessed on computed tomography before chemotherapy. Each patient’s total psoas area was measured at the lumbar vertebrae (L3) and sarcopenia was defined as median values or lower. Predictive factors for myelosuppression were assessed using logistic regression analysis and survival was evaluated using Cox regression analysis.


The patients’ mean age was 71.6 years (range 44.4–89.2 years). Of the initial 80 patients, 39 were diagnosed with sarcopenia and 26 of 53 patients with metastatic UC were diagnosed with sarcopenia. Sarcopenia was an independent predictive factor (P = 0.030; odds ratio, 3.526; 95% confidence interval [CI] 1.128–11.01) for neutropenia on multivariate analysis. Patients without sarcopenia had a significantly longer OS compared to those with sarcopenia (P = 0.013). Sarcopenia and albumin (P = 0.045, 0.023; hazard ratio (HR), 2.309, 2.652; 95% CI 1.021–5.225, 1.141–6.165, respectively) were independent predictors of OS in multivariate analysis.


Sarcopenia was predictive for neutropenia associated with GC or GCa in UC patients and OS in metastatic UC.


Urothelial carcinoma Sarcopenia Chemotherapy Hematologic side effect Overall survival 


Compliance with ethical standards

Conflict of interest

The authors have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

The need for informed consent was waived because of the retrospective nature of the study.


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Copyright information

© Japan Society of Clinical Oncology 2019

Authors and Affiliations

  • Tetsuya Yumioka
    • 1
  • Masashi Honda
    • 1
    Email author
  • Ryoma Nishikawa
    • 1
  • Shogo Teraoka
    • 1
  • Yusuke Kimura
    • 1
  • Hideto Iwamoto
    • 1
  • Shuichi Morizane
    • 1
  • Katsuya Hikita
    • 1
  • Atsushi Takenaka
    • 1
  1. 1.Division of Urology, Department of SurgeryTottori University Faculty of MedicineYonagoJapan

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