Sarcopenic Obesity in Cervical Carcinoma: A Strong and Independent Prognostic Factor beyond the Conventional Predictors (ESTHER Study-AFRAID Project).
Federica MediciCostanza Maria DonatiSilvia CammelliLudovica ForlaniViola LaghiJohnny MaSavino CillaMilly BuwengeGabriella MacchiaFrancesco DeodatoMaria VadalàClaudio MaliziaLuca TagliaferriAnna Myriam PerronePierandrea De IacoLidia StrigariAlberto BazzocchiStefania Maria Rita RizzoAlessandra ArcelliAlessio Giuseppe MorgantiPublished in: Cancers (2024)
Locally advanced cervical cancer represents a significant treatment challenge. Body composition parameters such as body mass index, sarcopenia, and sarcopenic obesity, defined by sarcopenia and BMI ≥ 30 kg/m 2 , have been identified as potential prognostic factors, yet their overall impact remains underexplored. This study assessed the relationship between these anthropometric parameters alongside clinical prognostic factors on the prognosis of 173 cervical cancer patients. Survival outcomes in terms of local control (LC), distant metastasis-free survival (DMFS), disease-free survival (DFS), and overall survival (OS) were analyzed using Kaplan regression methods-Meier and Cox. Older age, lower hemoglobin levels, higher FIGO (International Federation of Gynecology and Obstetrics) stages, and lower total radiation doses were significantly associated with worse outcomes. Univariate analysis showed a significant correlation between BMI and the outcomes examined, revealing that normal-weight patients show higher survival rates, which was not confirmed by the multivariate analysis. Sarcopenia was not correlated with any of the outcomes considered, while sarcopenic obesity was identified as an independent negative predictor of DFS (HR: 5.289, 95% CI: 1.298-21.546, p = 0.020) and OS (HR: 2.645, 95% CI: 1.275-5.488, p = 0.009). This study highlights the potential of sarcopenic obesity as an independent predictor of clinical outcomes. These results support their inclusion in prognostic assessments and treatment planning for patients with advanced cervical cancer.
Keyphrases
- prognostic factors
- free survival
- body mass index
- weight gain
- body composition
- weight loss
- metabolic syndrome
- insulin resistance
- type diabetes
- physical activity
- squamous cell carcinoma
- skeletal muscle
- high fat diet induced
- locally advanced
- end stage renal disease
- chronic kidney disease
- lymph node
- bone mineral density
- rectal cancer
- neoadjuvant chemotherapy
- risk assessment
- peritoneal dialysis
- resistance training
- postmenopausal women
- body weight
- high intensity
- red blood cell