Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan.
Center for Postgraduate Clinical Training and Career Development, Nagoya University Hospital, Nagoya, Aichi, Japan.
Nutr Clin Pract. 2020 Dec;35(6):1041-1046. doi: 10.1002/ncp.10482. Epub 2020 Apr 6.
This study was conducted to investigate the prognostic significance of sarcopenia in patients with organ metastatic cervical cancer.
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.
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 cm /m . Patients with a PMI > 3.72 cm /m had significantly better OS than those with a PMI ≤ 3.72 cm /m (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 cm /m who underwent concurrent chemoradiotherapy (CCRT) had a longer OS than those receiving other therapies (P < .001).
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 cm /m may benefit from CCRT as an initial treatment.
本研究旨在探讨肌肉减少症在有器官转移的宫颈癌患者中的预后意义。
回顾性分析 2004 年 12 月至 2017 年 12 月在我院治疗的 40 例有器官转移的宫颈癌患者的资料,采用单因素和多因素分析评估临床病理特征与生存的相关性。采用 CT 图像测量第 3 腰椎水平的竖脊肌面积计算的竖脊肌指数(psoas muscle index,PMI)作为肌肉减少症的指标。
中位随访时间为 14 个月(1-91 个月)。Kaplan-Meier 分析显示,所有患者的 3 年和 5 年总生存率(overall survival,OS)分别为 46.1%和 35.8%。最大曲线下面积的受试者工作特征曲线显示,预测 1 年生存的最佳 PMI 为 3.72cm/m。PMI>3.72cm/m 的患者 OS 明显优于 PMI≤3.72cm/m 的患者(P=0.046)。多因素分析显示,只有 PMI 与有器官转移的宫颈癌患者的 OS 显著相关。此外,PMI>3.72cm/m 的患者接受同期放化疗(concurrent chemoradiotherapy,CCRT)的 OS 长于接受其他治疗的患者(P<0.001)。
高 PMI 被确定为有器官转移的宫颈癌患者的有利预后因素。此外,PMI>3.72cm/m 的有器官转移的宫颈癌患者可能从 CCRT 作为初始治疗中获益。