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Journals / Sakarya Tıp Dergisi / 2026 / Volume: 16 Issue: 2

Impact of Preoperative Sarcopenia on Perioperative Complications and Functional Outcomes, and Biochemical Recurrence Following Radical Prostatectomy: Single-Institution Experience, Retrospective Cohort Study

Anıl Erdik(SAKARYA KARASU STATE HOSPITAL, DEPARTMENT OF UROLOGY)0000-0002-5132-7447
Hacı İbrahim Çimen(SAKARYA UNIVERSITY, SCHOOL OF MEDICINE)0000-0002-0284-3926
Deniz Gül(SAKARYA RESEARCH AND TRAINING HOSPITAL, DEPARTMENT OF UROLOGY)0000-0003-0873-0000
Kemal Demirhan(BOLU GEREDE STATE HOSPITAL, DEPARTMENT OF UROLOGY)0000-0002-1373-5239
Yasir Muhammed Akca(SAKARYA UNIVERSITY, SCHOOL OF MEDICINE)0000-0002-9121-8819
Onur Taydaş(SAKARYA UNIVERSITY, SCHOOL OF MEDICINE)0000-0002-9881-7240
Pages
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Publication Date
2026-06-30
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AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

Sarcopenia may primarily serve as an indicator of surgical vulnerability rather than oncological prognosis.

📌 3 Key Takeaways

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Objective & Hypothesis:Objective: Sarcopenia is increasingly recognized as a marker of frailty and a predictor of adverse outcomes in surgical oncology.
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Key Findings & Data:Methods: We retrospectively analyzed 165 men who underwent RP between 2015 and 2025 at a single institution.
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Conclusion & Impact:Sarcopenia may primarily serve as an indicator of surgical vulnerability rather than oncological prognosis.
🔬Design:Research Article
📍Scope:2015 Verileri
⚙️Variables:Biochemical recurrence · Prostate cancer · Radical prostatectomy

Abstract

Objective: Sarcopenia is increasingly recognized as a marker of frailty and a predictor of adverse outcomes in surgical oncology. However, its role in patients undergoing radical prostatectomy (RP) for localized prostate cancer (PCa) remains unclear. Methods: We retrospectively analyzed 165 men who underwent RP between 2015 and 2025 at a single institution. Sarcopenia was assessed using preoperative CT-derived skeletal muscle index (SMI). Perioperative complications, pathological outcomes, urinary continence, erectile function, biochemical recurrence (BCR), and all-cause mortality (ACM) were com-pared between sarcopenic and non-sarcopenic patients. Statistical analyses included the Mann–Whitney U test, chi-square test, Kaplan–Meier analysis with the log-rank test, and Cox proportional hazards regression. Results: Of the cohort, 75 patients (45.5%) were sarcopenic. These patients were older (median age 69 vs. 66 years, p=0.005) and had higher comorbidity scores (CCI ≥5: 56.0% vs. 32.2%, p=0.002). Major complications (Clavien-Dindo ≥3) occurred more frequently in the sarcopenic group (10.7% vs. 1.1%, p=0.007), although no perioperative mortality was observed. Continence status at 12 months was comparable between the groups (p=0.373). IIEF-5 scores were lower in sarcopenic patients at 12 months (median, 10 vs. 12; p=0.021); however, baseline IIEF-5 scores also differed significantly between the groups. During a median follow-up of 37 months, 65 patients developed BCR and 11 died (7 sarcopenic). Cumulative incidence of biochemical recurrence was 44% at the median follow-up. Although sarcopenic patients showed a higher recurrence trend (≈65% vs. 37%), no statistically significant difference was observed (p=0.267). In Cox Regression analysis, sarcopenia did not appear to significantly predict BCR (HR 0.75, 95% CI 0.45–1.24, p=0.272). Conclusions: Preoperative sarcopenia may be associated with increased major perioperative complications and impaired erectile function following RP. However, it was not significantly associated with BCR in this cohort. Sarcopenia may primarily serve as an indicator of surgical vulnerability rather than oncological prognosis.

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Cite This Article

Erdik, A., Çimen, H. İ., Gül, D., Demirhan, K., Akca, Y. M., Taydaş, O., *, A. E. (2026). Impact of Preoperative Sarcopenia on Perioperative Complications and Functional Outcomes, and Biochemical Recurrence Following Radical Prostatectomy: Single-Institution Experience, Retrospective Cohort Study. Sakarya Tıp Dergisi, Volume: 16 Issue: 2. https://doi.org/10.31832/smj.1889266

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