Poor Pre-Op Nutrition Tied to Mortality Risk After Cystectomy

Nutritional deficiency linked to poor overall survival after radical cystectomy for bladder cancer

FRIDAY, Jan. 14 (HealthDay News) -- Nutritional deficiency, as measured by preoperative weight loss, serum albumin, and body mass index (BMI), is a strong predictor of poor overall survival and 90-day mortality in patients undergoing radical cystectomy (RC) for urothelial carcinoma, according to research published in the January issue of The Journal of Urology.

Justin R. Gregg, of the Vanderbilt University Medical Center in Nashville, Tenn., and colleagues performed a retrospective cohort study of 538 patients who underwent RC for urothelial carcinoma between January 2000 and June 2008.

The researchers found that 103 patients (19 percent) met the criteria for nutritional deficiency, defined as preoperative albumin less than 3.5 gm/dL, BMI less than 18.5 kg/m², or preoperative weight loss greater than 5 percent of body weight. At 90 days, the mortality rate was 7.3 percent (39 deaths), which included 16.5 percent of the nutritionally deficient patients and 5.1 percent of the others. At three years, the survival rate was only 44.5 percent for nutritionally deficient patients versus 67.6 percent for the others.

"Prospective studies are needed to identify the most important components of a preoperative nutritional evaluation and to determine the potential impact of nutritional intervention in nutritionally deficient patients undergoing RC," the authors write.

Several authors disclosed financial and/or other relationships with pharmaceutical companies.

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