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Erschienen in: World Journal of Urology 4/2021

09.06.2020 | Original Article

The impact of preoperative nutritional status on post-surgical complication and mortality rates in patients undergoing radical cystectomy for bladder cancer: a systematic review of the literature

verfasst von: Paola Irene Ornaghi, Luca Afferi, Alessandro Antonelli, Maria Angela Cerruto, Katia Odorizzi, Alessandra Gozzo, Livio Mordasini, Agostino Mattei, Philipp Baumeister, Julian Cornelius, Alessandro Tafuri, Marco Moschini

Erschienen in: World Journal of Urology | Ausgabe 4/2021

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Abstract

Purpose

To investigate the impact of preoperative nutritional factors [body mass index (BMI)], hypoalbuminemia (< 3.5 g/dL, sarcopenia) on complication and mortality rates after radical cystectomy (RC) for bladder cancer.

Methods

The PubMed database was systematically searched for studies investigating the effect of nutritional status on postoperative outcomes after RC. English-language articles published between March 2010 and March 2020 were reviewed. For statistical analyses odds ratios (ORs) and hazard ratios (HRs) weighted mean was applied.

Results

Overall, 81 studies were included. Twenty-nine studies were enrolled in the final analyses. Patients with a 25–29.9 kg/m2 BMI (OR 1.55, 95% confidence interval [CI] 1.14–2.07) and those with a BMI ≥ 30 kg/m2 (OR 1.73, 95% CI 1.29–2.40) had a significantly increased risk of 30 day complications after RC. Preoperative hypoalbuminemia increased the risk of 30 day complications (OR 1.56, 95% CI 1.07–2.35); it was a predictor of worse 3 year overall survival (OS) (HR 1.86, 95% CI 1.32–2.66). Sarcopenic patients had a higher risk of 90 day complications than non-sarcopenic ones (OR 2.49, 95% CI 1.22–5.04). Sarcopenia was significantly associated with unfavorable 5 year cancer-specific survival (CSS) (HR 1.73, 95% CI 1.07–2.80), and OS (HR 1.60, 95% CI 1.13–2.25).

Conclusion

High BMI, hypoalbuminemia, and sarcopenia significantly increased the complication rate after RC. Hypoalbuminemia predicted worse 3 year OS and sarcopenia predicted unfavorable 5 year CSS and OS. Preoperative assessment of RC patients’ nutritional status is a useful tool to predict perioperative and survival outcomes.
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Metadaten
Titel
The impact of preoperative nutritional status on post-surgical complication and mortality rates in patients undergoing radical cystectomy for bladder cancer: a systematic review of the literature
verfasst von
Paola Irene Ornaghi
Luca Afferi
Alessandro Antonelli
Maria Angela Cerruto
Katia Odorizzi
Alessandra Gozzo
Livio Mordasini
Agostino Mattei
Philipp Baumeister
Julian Cornelius
Alessandro Tafuri
Marco Moschini
Publikationsdatum
09.06.2020
Verlag
Springer Berlin Heidelberg
Erschienen in
World Journal of Urology / Ausgabe 4/2021
Print ISSN: 0724-4983
Elektronische ISSN: 1433-8726
DOI
https://doi.org/10.1007/s00345-020-03291-z

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