Sarcopenia as a Predictor of Survival Among Patients With Organ Metastatic Cervical Cancer
2020
Yoshikawa, Nobuhisa | Shirakawa, Akira | Yoshida, Kosuke | Tamauchi, Satoshi | Suzuki, Shiro | Kikkawa, Fumitaka | Kajiyama, Hiroaki
BACKGROUND: This study was conducted to investigate the prognostic significance of sarcopenia in patients with organ metastatic cervical cancer. METHODS: Accordingly, the data of 40 patients with organ metastatic cervical cancer treated at our institute from December 2004 to December 2017 were retrospectively analyzed. The correlation between clinicopathological characteristics and survival was then evaluated using univariate and multivariate analyses. Psoas muscle index (PMI), calculated from the psoas muscle area at the L3 vertebral‐body level using computed tomography images obtained for pretreatment evaluation, was adopted as an index of sarcopenia. RESULTS: The median follow‐up period was 14 months (range, 1–91 months). Kaplan‐Meier analysis showed a 3‐ and 5‐year overall survival (OS) rate of 46.1% and 35.8% for all patients, respectively. Receiver operating characteristic curve maximizing the area under the curve showed that the optimal PMI for predicting 1‐year survival was 3.72 cm²/m². Patients with a PMI > 3.72 cm²/m² had significantly better OS than those with a PMI ≤ 3.72 cm²/m² (P = .046). Multivariate analysis revealed that only PMI was significantly associated with OS in patients with organ metastatic cervical cancer. Furthermore, patients with a PMI > 3.72 cm²/m² who underwent concurrent chemoradiotherapy (CCRT) had a longer OS than those receiving other therapies (P < .001). CONCLUSIONS: High PMI was determined to be a favorable prognostic factor for patients with organ metastatic cervical cancer. Moreover, patients with organ metastatic cervical cancer who have a PMI > 3.72 cm²/m² may benefit from CCRT as an initial treatment.
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