236P - The effects of chemotherapy on body composition in patients with advanced urothelial carcinoma

Background

This study aimed to determine the changes to body composition and the risk of adverse effects associated with chemotherapy in patients with advanced urothelial carcinoma (UC). The study also investigated whether bioimpedance analysis (BIA) is an effective method for diagnosing body composition.

Methods

We prospectively evaluated the body composition of 60 patients with locoregional muscle invasive (≥ T2 and N0-2M0) or metastatic UC between April 2021 and June 2023 at the Department of Urology, Juntendo Nerima Hospital, Tokyo, Japan. Body composition was evaluated using multifrequency BIA at baseline and during chemotherapy. The change in body composition was compared between before and during chemotherapy, and the incidence of adverse events was also determined.

Results

Twelve of the 60 patients enrolled in the study failed to complete their planned chemotherapy regimens or the chemotherapy regimen was discontinued or changed due to adverse events or problems related to underlying cancer. The patients who discontinued their treatment were significantly older and had a low muscle mass and a low skeletal muscle index. To assess the time-course changes in the body composition of the 41 patients who underwent chemotherapy, BIA was performed before each cycle. Chemotherapy-associated changes included a reduction in body weight 1.3% (±0.6%) and a decrease in fat mass 6.4% (±3.4%), while muscle mass did not change 0 .0% (±0.8%) between each cycle. Patients, aged 75 years or younger, had a more significant loss of muscle mass than older patients with a low muscle mass at baseline. (2.3% ± 1.0 % vs -1.4% ±1.1%, p=0.033).

Conclusions

BIA may be used as a method of nutrition and muscle assessment for pretreatment risk stratification of patients with advanced UC treated with chemotherapy. Moreover, our findings suggest that elderly patients with a low muscle mass may have trouble completing their chemotherapy course. Furthermore, chemotherapy is associated with changes in body composition which may lead to a loss of muscle mass in non-elderly patients.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.