Visceral Adipose Predicts Prognosis and Toxicities in Locally Advanced Bladder Cancer Patients Treated With Adjuvant Gemcitabine Plus Cisplatin Chemotherapy

IF 3.1 2区医学 Q2 ONCOLOGY

Cancer Medicine Pub Date : 2025-03-27 DOI:10.1002/cam4.70742

Zhimin Gao, Lei Zhang, Zhen Li, Xu Qin, Zewei Wang, Junqi Wang, Nienie Qi, Hailong Li

{"title":"Visceral Adipose Predicts Prognosis and Toxicities in Locally Advanced Bladder Cancer Patients Treated With Adjuvant Gemcitabine Plus Cisplatin Chemotherapy","authors":"Zhimin Gao, Lei Zhang, Zhen Li, Xu Qin, Zewei Wang, Junqi Wang, Nienie Qi, Hailong Li","doi":"10.1002/cam4.70742","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Purpose</h3>\n \n <p>For patients with bladder cancer (BC) undergoing radical cystectomy followed by adjuvant chemotherapy, the impact of visceral adipose tissue on prognosis and chemotherapy-related toxicities has not been well established.</p>\n </section>\n \n <section>\n \n <h3> Materials and Methods</h3>\n \n <p>From July 2013 to November 2020, 224 BC patients received adjuvant gemcitabine plus cisplatin at our institution. Computed tomography images of the patients were analyzed to calculate the visceral adipose tissue index (VATI). Patients were stratified into high- and low-VATI groups based on a predetermined cutoff value, and differences in prognosis and chemotherapy-related adverse events (AEs) between the two groups were compared.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>After propensity score matching, a total of 166 patients were enrolled, with 83 in the low-VATI group and 83 in the high-VATI group. The low-VATI group exhibited notably extended progression-free survival (PFS) in comparison to the high-VATI group (<i>p</i> = 0.044). Conversely, no substantial variation was noted concerning overall survival (OS) among the patient cohorts. In the multivariable Cox regression analysis, patients aged over 70 years (HR = 1.66, 95% CI 1.09–2.57, <i>p</i> = 0.04) and nodal positivity (HR = 2.98, 95% CI 1.04–4.28, <i>p</i> = 0.01) emerged as significant risk factors for OS. In addition to the level of VATI (HR = 2.47, 95% CI 1.02–4.21, <i>p</i> = 0.04), nodal positivity (HR = 4.04, 95% CI 1.30–12.56, <i>p</i> = 0.02) remained a significant risk factor for PFS. Regarding chemotherapy-related AEs, the most common AEs of any grade and grade ≥ 3 were hematologic toxicities. Patients in the low-VATI group exhibited a higher likelihood of experiencing grade ≥ 3 neutropenia compared to those in the high-VATI group (<i>p</i> = 0.04).</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>This study demonstrated that, among patients treated with adjuvant chemotherapy for locally advanced BC, patients in the low-VATI group exhibited a significantly prolonged PFS compared to those in the high-VATI group. However, no significant difference was observed in terms of OS. Regarding chemotherapy-related AEs, patients in the high-VATI group exhibited a relatively lower incidence and severity of toxic reactions.</p>\n </section>\n </div>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"14 7","pages":""},"PeriodicalIF":3.1000,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cam4.70742","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Cancer Medicine","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1002/cam4.70742","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ONCOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Purpose

For patients with bladder cancer (BC) undergoing radical cystectomy followed by adjuvant chemotherapy, the impact of visceral adipose tissue on prognosis and chemotherapy-related toxicities has not been well established.

Materials and Methods

From July 2013 to November 2020, 224 BC patients received adjuvant gemcitabine plus cisplatin at our institution. Computed tomography images of the patients were analyzed to calculate the visceral adipose tissue index (VATI). Patients were stratified into high- and low-VATI groups based on a predetermined cutoff value, and differences in prognosis and chemotherapy-related adverse events (AEs) between the two groups were compared.

Results

After propensity score matching, a total of 166 patients were enrolled, with 83 in the low-VATI group and 83 in the high-VATI group. The low-VATI group exhibited notably extended progression-free survival (PFS) in comparison to the high-VATI group (p = 0.044). Conversely, no substantial variation was noted concerning overall survival (OS) among the patient cohorts. In the multivariable Cox regression analysis, patients aged over 70 years (HR = 1.66, 95% CI 1.09–2.57, p = 0.04) and nodal positivity (HR = 2.98, 95% CI 1.04–4.28, p = 0.01) emerged as significant risk factors for OS. In addition to the level of VATI (HR = 2.47, 95% CI 1.02–4.21, p = 0.04), nodal positivity (HR = 4.04, 95% CI 1.30–12.56, p = 0.02) remained a significant risk factor for PFS. Regarding chemotherapy-related AEs, the most common AEs of any grade and grade ≥ 3 were hematologic toxicities. Patients in the low-VATI group exhibited a higher likelihood of experiencing grade ≥ 3 neutropenia compared to those in the high-VATI group (p = 0.04).

Conclusions

This study demonstrated that, among patients treated with adjuvant chemotherapy for locally advanced BC, patients in the low-VATI group exhibited a significantly prolonged PFS compared to those in the high-VATI group. However, no significant difference was observed in terms of OS. Regarding chemotherapy-related AEs, patients in the high-VATI group exhibited a relatively lower incidence and severity of toxic reactions.

Abstract Image

查看原文本刊更多论文

内脏脂肪预测局部晚期膀胱癌患者吉西他滨加顺铂辅助化疗的预后和毒性

目的膀胱癌（BC）患者行根治性膀胱切除术后辅助化疗，内脏脂肪组织对预后和化疗相关毒性的影响尚不清楚。材料与方法2013年7月至2020年11月，我院224例BC患者接受吉西他滨+顺铂辅助治疗。分析患者的计算机断层扫描图像，计算内脏脂肪组织指数（VATI）。根据预先设定的临界值将患者分为高vati组和低vati组，比较两组患者预后和化疗相关不良事件（ae）的差异。结果经倾向评分匹配后，共纳入166例患者，其中低vati组83例，高vati组83例。与高vati组相比，低vati组的无进展生存期（PFS）明显延长（p = 0.044）。相反，在患者队列中，总生存期（OS）没有实质性变化。在多变量Cox回归分析中，患者年龄超过70岁（HR = 1.66, 95% CI 1.09-2.57, p = 0.04）和淋巴结阳性（HR = 2.98, 95% CI 1.04-4.28, p = 0.01）成为OS的显著危险因素。除了VATI水平（HR = 2.47, 95% CI 1.02-4.21, p = 0.04）外，淋巴结阳性（HR = 4.04, 95% CI 1.30-12.56, p = 0.02）仍然是PFS的重要危险因素。对于化疗相关的不良事件，任何级别和≥3级最常见的不良事件是血液学毒性。与高vati组相比，低vati组患者出现≥3级中性粒细胞减少的可能性更高（p = 0.04）。本研究表明，在局部晚期BC的辅助化疗患者中，与高vati组相比，低vati组患者的PFS明显延长。然而，在OS方面没有观察到显著差异。对于化疗相关不良反应，高vati组患者毒性反应的发生率和严重程度相对较低。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Cancer Medicine ONCOLOGY-

CiteScore

5.50

自引率

2.50%

发文量

907

审稿时长

19 weeks

期刊介绍： Cancer Medicine is a peer-reviewed, open access, interdisciplinary journal providing rapid publication of research from global biomedical researchers across the cancer sciences. The journal will consider submissions from all oncologic specialties, including, but not limited to, the following areas: Clinical Cancer Research Translational research ∙ clinical trials ∙ chemotherapy ∙ radiation therapy ∙ surgical therapy ∙ clinical observations ∙ clinical guidelines ∙ genetic consultation ∙ ethical considerations Cancer Biology: Molecular biology ∙ cellular biology ∙ molecular genetics ∙ genomics ∙ immunology ∙ epigenetics ∙ metabolic studies ∙ proteomics ∙ cytopathology ∙ carcinogenesis ∙ drug discovery and delivery. Cancer Prevention: Behavioral science ∙ psychosocial studies ∙ screening ∙ nutrition ∙ epidemiology and prevention ∙ community outreach. Bioinformatics: Gene expressions profiles ∙ gene regulation networks ∙ genome bioinformatics ∙ pathwayanalysis ∙ prognostic biomarkers. Cancer Medicine publishes original research articles, systematic reviews, meta-analyses, and research methods papers, along with invited editorials and commentaries. Original research papers must report well-conducted research with conclusions supported by the data presented in the paper.