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Thomas Flaig, MD


BCG After Transurethral Resection of Bladder Cancer: How Body Composition May Impact Outcomes

By: Celeste L. Dixon
Posted: Friday, May 26, 2023

When treating non–muscle-invasive bladder cancer with transurethral resection of bladder tumor and adjuvant intravesical instillation with bacillus Calmette-Guérin (BCG), patients who do not have sarcopenia and/or are obese may be more likely to tolerate therapy. In turn, they may have better oncologic outcomes than patients who are sarcopenic and/or not obese, according to a retrospective study of 269 patients treated between 2005 and 2021. Li-Jen Wang, MD, of Chang Gung University, Taoyuan, Taiwan, and colleagues reported their work at the American Urological Association (AUA) Annual Meeting 2023 (Abstract MP08-11) and published the details in The Journal of Urology.

Oncologic outcomes were evaluated in the 269 patients, almost all of whom had disease at stage Ta (44.6%) or T1 (50.9%). A total of 80 patients (29.7%) were sarcopenic, and 53 (19.7%) were obese. Patients with sarcopenia had poorer recurrence-free survival (P = .030) and overall survival (P = .033), whereas obese patients had better overall survival (P = .008). Further, subcutaneous adipose tissue density on CT was a significant predictor for recurrence-free survival (P = .011). Psoas muscle density also had a significant impact on overall survival (P = .044) in multivariate analysis.

Previous literature has demonstrated mixed results on the influence of obesity on bladder cancer prognosis, and high body mass index has been shown to be an independent risk factor for bladder cancer, noted Dr. Wang and co-investigators. Nonetheless, they concluded, because “nonsarcopenic and obese patients can endure significantly more BCG intravesical instillation…, body composition measurements have potential in assessments of oncological outcomes of patients with non–muscle-invasive bladder cancer.”

Disclosure: No disclosure information was provided.

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