Sarcopenic Obesity in Cervical Carcinoma: A Strong and Independent Prognostic Factor beyond the Conventional Predictors (ESTHER Study—AFRAID Project)
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<sup>2</sup>, have been identified as potential prognostic factors, yet their ove...
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| Format: | Article |
| Language: | English |
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MDPI AG
2024-02-01
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| Series: | Cancers |
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| Online Access: | https://www.mdpi.com/2072-6694/16/5/929 |
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| author | Federica Medici Martina Ferioli Silvia Cammelli Ludovica Forlani Viola Laghi Johnny Ma Savino Cilla Milly Buwenge Gabriella Macchia Francesco Deodato Maria Vadalà Claudio Malizia Luca Tagliaferri Anna Myriam Perrone Pierandrea De Iaco Lidia Strigari Alberto Bazzocchi Stefania Rizzo Alessandra Arcelli Alessio Giuseppe Morganti |
| author_facet | Federica Medici Martina Ferioli Silvia Cammelli Ludovica Forlani Viola Laghi Johnny Ma Savino Cilla Milly Buwenge Gabriella Macchia Francesco Deodato Maria Vadalà Claudio Malizia Luca Tagliaferri Anna Myriam Perrone Pierandrea De Iaco Lidia Strigari Alberto Bazzocchi Stefania Rizzo Alessandra Arcelli Alessio Giuseppe Morganti |
| author_sort | Federica Medici |
| collection | DOAJ |
| description | 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<sup>2</sup>, 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, <i>p</i> = 0.020) and OS (HR: 2.645, 95% CI: 1.275–5.488, <i>p</i> = 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. |
| first_indexed | 2024-04-25T00:33:43Z |
| format | Article |
| id | doaj.art-c63e99749736445c816a653f8c75a25c |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-04-25T00:33:43Z |
| publishDate | 2024-02-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-c63e99749736445c816a653f8c75a25c2024-03-12T16:40:53ZengMDPI AGCancers2072-66942024-02-0116592910.3390/cancers16050929Sarcopenic Obesity in Cervical Carcinoma: A Strong and Independent Prognostic Factor beyond the Conventional Predictors (ESTHER Study—AFRAID Project)Federica Medici0Martina Ferioli1Silvia Cammelli2Ludovica Forlani3Viola Laghi4Johnny Ma5Savino Cilla6Milly Buwenge7Gabriella Macchia8Francesco Deodato9Maria Vadalà10Claudio Malizia11Luca Tagliaferri12Anna Myriam Perrone13Pierandrea De Iaco14Lidia Strigari15Alberto Bazzocchi16Stefania Rizzo17Alessandra Arcelli18Alessio Giuseppe Morganti19Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, 40138 Bologna, ItalyDepartment of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, 40138 Bologna, ItalyDepartment of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, 40138 Bologna, ItalyDepartment of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, 40138 Bologna, ItalyDepartment of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, 40138 Bologna, ItalyDepartment of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, 40138 Bologna, ItalyMedical Physics Unit, Gemelli Molise Hospital—Università Cattolica del Sacro Cuore, 86100 Campobasso, ItalyDepartment of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, 40138 Bologna, ItalyRadiotherapy Unit, Gemelli Molise Hospital, Fondazione Policlinico Universitario A. Gemelli, IRCCS, 86100 Campobasso, ItalyRadiotherapy Unit, Gemelli Molise Hospital, Fondazione Policlinico Universitario A. Gemelli, IRCCS, 86100 Campobasso, ItalyNuclear Medicine, IRCCS Azienda Ospedaliero—Universitaria di Bologna, 40138 Bologna, ItalyNuclear Medicine, IRCCS Azienda Ospedaliero—Universitaria di Bologna, 40138 Bologna, ItalyUOC di Radioterapia Oncologica, Dipartimento Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Roma, ItalyDepartment of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, 40138 Bologna, ItalyDepartment of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, 40138 Bologna, ItalyMedical Physics, IRCCS Azienda Ospedaliero—Universitaria di Bologna, 40138 Bologna, ItalyDiagnostic and Interventional Radiology, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, ItalyService of Radiology, Imaging Institute of Southern Switzerland, Ente Ospedaliero Cantonale (EOC), CH-6500 Lugano, SwitzerlandDepartment of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, 40138 Bologna, ItalyDepartment of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, 40138 Bologna, ItalyLocally 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<sup>2</sup>, 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, <i>p</i> = 0.020) and OS (HR: 2.645, 95% CI: 1.275–5.488, <i>p</i> = 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.https://www.mdpi.com/2072-6694/16/5/929anemiabody mass indexchemoradiationcervical cancerhemoglobinobservational study |
| spellingShingle | Federica Medici Martina Ferioli Silvia Cammelli Ludovica Forlani Viola Laghi Johnny Ma Savino Cilla Milly Buwenge Gabriella Macchia Francesco Deodato Maria Vadalà Claudio Malizia Luca Tagliaferri Anna Myriam Perrone Pierandrea De Iaco Lidia Strigari Alberto Bazzocchi Stefania Rizzo Alessandra Arcelli Alessio Giuseppe Morganti Sarcopenic Obesity in Cervical Carcinoma: A Strong and Independent Prognostic Factor beyond the Conventional Predictors (ESTHER Study—AFRAID Project) Cancers anemia body mass index chemoradiation cervical cancer hemoglobin observational study |
| title | Sarcopenic Obesity in Cervical Carcinoma: A Strong and Independent Prognostic Factor beyond the Conventional Predictors (ESTHER Study—AFRAID Project) |
| title_full | Sarcopenic Obesity in Cervical Carcinoma: A Strong and Independent Prognostic Factor beyond the Conventional Predictors (ESTHER Study—AFRAID Project) |
| title_fullStr | Sarcopenic Obesity in Cervical Carcinoma: A Strong and Independent Prognostic Factor beyond the Conventional Predictors (ESTHER Study—AFRAID Project) |
| title_full_unstemmed | Sarcopenic Obesity in Cervical Carcinoma: A Strong and Independent Prognostic Factor beyond the Conventional Predictors (ESTHER Study—AFRAID Project) |
| title_short | Sarcopenic Obesity in Cervical Carcinoma: A Strong and Independent Prognostic Factor beyond the Conventional Predictors (ESTHER Study—AFRAID Project) |
| title_sort | sarcopenic obesity in cervical carcinoma a strong and independent prognostic factor beyond the conventional predictors esther study afraid project |
| topic | anemia body mass index chemoradiation cervical cancer hemoglobin observational study |
| url | https://www.mdpi.com/2072-6694/16/5/929 |
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