Extreme leanness, lower skeletal muscle quality, and loss of muscle mass during treatment are predictors of poor prognosis in cervical cancer treated with concurrent chemoradiation therapy.

Autor: Abe A; Department of Gynecology, Cancer Institute Hospital, 3-8-31, Ariake, Koto-ku, Tokyo, 135-8550, Japan. akiko06090111akiko@gmail.com.; Department of Obstetrics and Gynecology, Tokushima University, 3-18-15 Kuramoto-cho, Tokushima, 770-8503, Japan. akiko06090111akiko@gmail.com., Yuasa M; Department of Radiology, Tokushima University Hospital, 3-18-15 Kuramoto-cho, Tokushima, 770-8503, Japan., Imai Y; Department of Biomedical Sciences, Tokushima University, 3-18-15 Kuramoto-cho, Tokushima, 770-8503, Japan., Kagawa T; Department of Obstetrics and Gynecology, Tokushima University, 3-18-15 Kuramoto-cho, Tokushima, 770-8503, Japan., Mineda A; Department of Obstetrics and Gynecology, Tokushima University, 3-18-15 Kuramoto-cho, Tokushima, 770-8503, Japan., Nishimura M; Department of Obstetrics and Gynecology, Tokushima University, 3-18-15 Kuramoto-cho, Tokushima, 770-8503, Japan., Tonoiso C; Department of Radiology, Tokushima University, 3-18-15 Kuramoto-cho, Tokushima, 770-8503, Japan., Kubo A; Department of Radiology, Tokushima University, 3-18-15 Kuramoto-cho, Tokushima, 770-8503, Japan., Kawanaka T; Department of Radiology, Tokushima University, 3-18-15 Kuramoto-cho, Tokushima, 770-8503, Japan., Ikushima H; Department of Therapeutic Radiology, Tokushima University Graduate School, 3-18-15 Kuramoto-cho, Tokushima, 770-8503, Japan., Iwasa T; Department of Obstetrics and Gynecology, Tokushima University, 3-18-15 Kuramoto-cho, Tokushima, 770-8503, Japan.
Jazyk: angličtina
Zdroj: International journal of clinical oncology [Int J Clin Oncol] 2022 May; Vol. 27 (5), pp. 983-991. Date of Electronic Publication: 2022 Feb 25.
DOI: 10.1007/s10147-022-02140-w
Abstrakt: Background: Human papillomavirus vaccination is not widespread in Japan, and the low screening rates result in many cases of locally advanced cervical cancer. We investigated the prognostic significance of sarcopenia in patients with cervical cancer to guide healthcare policies to improve treatment outcomes.
Methods: This retrospective study included 83 patients with cervical cancer without distant metastasis who underwent primary concurrent chemoradiotherapy between 2013 and 2018. We analyzed the indicators of physical condition and muscle quantity using the SYNAPSE VINCENT software. Muscle mass and the relationship between treatment toxicity and prognosis were evaluated.
Results: The patients' median age was 60 (range 33‒80) years. Cancer stage distribution was as follows: cT2b or higher, 84.3%; N1, 65.1%; and MA, 27.7%. The overall sarcopenia (skeletal muscle index [SMI] < 38.5) rate was 30.1%, and the rate was 33.9 and 22.2% in patients aged < 64 and ≥ 65 years, respectively. No correlation was observed between clinical stage and musculoskeletal indices. Treatment resulted in decreased body weight and SMI; after treatment, the sarcopenia rate increased to 37.3%. A higher intramuscular adipose tissue content (IMAC) reduced the number of chemotherapy cycles needed. Treatment-associated SMI decreases of ≥ 7% indicated poor prognosis, with significant differences in progression-free survival and overall survival (p = 0.013 and p = 0.012, respectively). Patients who were very lean (body mass index < 18.5 kg/m 2 ) before treatment had a poor prognosis (p = 0.016 and p < 0.001).
Conclusions: Our findings emphasize the importance of assessing original nutritional status and maintaining muscle mass and quality during the treatment of patients with cervical cancer.
(© 2022. The Author(s) under exclusive licence to Japan Society of Clinical Oncology.)
Databáze: MEDLINE
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