Clinical impact of sarcopenia in patients with uterine cervical cancer treated with radiotherapy

Abstract

Objective: Though sarcopenia is known to be associated with worse prognosis in various tumors, studies regarding the significance of sarcopenia in uterine cervical cancer are uncommon. We investigated the clinical impact of sarcopenia in patients with uterine cervical cancer treated with radiotherapy (RT). Methods: Among 104 patients who received RT for uterine cervical cancer between 2011 and 2018, 58 patients treated with a definitive or adjuvant aim were included in this study. Sarcopenia was determined by measuring the skeletal muscle area using computed tomography that was performed for RT planning. Results: Among the 58 patients, 30 patients (51.7%) had sarcopenia and 20 patients (66.7%) with sarcopenia had a normal body mass index (BMI). The median age of patients was 55.5 years. There was no linear relationship between age and prevalence of sarcopenia. During the median follow-up period of 35 months, 3 patients died and 11 patients had disease recurrence or progression. Sarcopenia was associated with a worse progression-free survival (PFS; HR 12.301, 95% CI 2.243–67.450, p = 0.004). The 2-year PFS rates of patients with and without sarcopenia were 66.3% and 92.3%, respectively (p = 0.008). Conclusions: Sarcopenia was observed in approximately half of the patients who received RT for cervical cancer, including patients with a normal BMI. Sarcopenia was associated with a worse PFS, and treatment interruption or discontinuation was more frequent among patients with sarcopenia. Evaluation of skeletal muscle mass and support to reduce skeletal muscle loss could be useful to optimize treatment and achieve better PFS.