Sarcopenia as a Predictor of Survival Among Patients With Organ Metastatic Cervical Cancer
Sarcopenia as a Predictor of Survival Among Patients With Organ Metastatic Cervical Cancer
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DOI：
10.1002/ncp.10482
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发表时间：
2020-04-06
影响因子：
3.1
通讯作者：
Kajiyama, Hiroaki
中科院分区：
文献类型：
--
作者：
Yoshikawa, Nobuhisa;Shirakawa, Akira;Kajiyama, Hiroaki
背景：本研究旨在探讨器官转移性宫颈癌患者肌钙蛋白减少的预后意义。方法对2004年12月至2017年12月收治的40例器官转移性宫颈癌患者的临床资料进行回顾性分析。然后使用单变量和多变量分析来评估临床病理特征与生存率之间的相关性。腰大肌指数(PMI)是根据L3椎体水平的腰大肌面积计算出来的，用CT图像进行预处理评估，作为骨质疏松症的指标。结果中位随访期14个月(1~91个月)。Kaplan-Meier分析显示，所有患者的3年和5年总生存率分别为46.1%和35.8%。以曲线下面积为最大的受试者操作特征曲线显示，预测1年生存率的最佳PMI为3.72 cm(2)/m(2)。同时接受放化疗(CCRT)的PMI和GT为3.72 cm(2)/m(2)的患者的OS显著好于PMI为3.72 cm(2)/m(2)的患者的OS比接受其他治疗的患者的OS更长(P<；.001)。结论高PMI是器官转移性宫颈癌患者良好的预后因素。此外，具有PMI和GT；3.72 cm(2)/m(2)的器官转移性宫颈癌患者可能受益于CCRT作为初始治疗。
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 cm(2)/m(2). Patients with a PMI > 3.72 cm(2)/m(2)had significantly better OS than those with a PMI 3.72 cm(2)/m(2)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 cm(2)/m(2)may benefit from CCRT as an initial treatment.