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Fig. 4 | BMC Cancer

Fig. 4

From: Clinical impact of postoperative loss in psoas major muscle and nutrition index after radical cystectomy for patients with urothelial carcinoma of the bladder

Fig. 4

Prognostic impacts of postoperative psoas muscle loss and nutritional deterioration. a. Time course of change (from baseline to 3 and 6 months) in the area of the psoas major muscle at the level of L3, on CT images, is shown for two representative patients. Case 1 (60 year-old man diagnosed with pT2a high-grade UC with nested variant) showed a 4% loss in muscle volume. There was no evidence of recurrence of metastases at 80 months after radical cystectomy. Case 2 (72 year-old man with pT3a high-grade pure UC) showed a 25% loss in muscle volume. A metastatic lesion was detected in the ileum at 31 months after cystectomy, and the patient died of bladder cancer at 54 months after radical cystectomyb. Impact of postoperative nutritional deterioration and psoas major muscle loss evaluated across all patients. A subanalysis according to sarcopenia status at baseline was performed. Hazard ratio and 95% confidence interval are plotted in the Table. P values are based on the comparison using the log-rank test. PNI, prognostic nutrition index; CONUT, Controlling Nutritional Status; DSS, disease-specific survival; OS, overall survival.c-e. The correlation between days of hospitalization after RC postoperative loss in volume of the psoas major muscle (c), decrease in PNI (d), and increase in CONUT score (e). The correlation was examined using Spearman’s correlation; Spearman ρ values and the 95% confidence intervals are shown in the Figures.

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