The role of sarcopenic obesity in high‐grade endometrial cancer

Abstract

Objective To investigate the relationship between obesity and sarcopenia in relation to overall survival (OS) and disease‐specific survival (DSS) in high‐grade endometrial cancer patients. Methods We conducted a retrospective study in women diagnosed with high‐grade endometrial cancer (EC) between February 2006 and August 2017 in the Royal Cornwall Hospital who had abdominal computerized tomography (CT)‐scan as part of routine staging work‐up. Sarcopenia was assessed by measuring psoas‐, paraspinal‐ and abdominal wall muscles on CT and defined by skeletal muscle index ≤41 cm2/m2. Sarcopenic obesity was defined as sarcopenia combined with body mass index (BMI) ≥30 kg/m2. Results A total of 176 patients with median age of 70 years and median BMI of 29.4 kg/m2 were included in the study. The majority of patients (38%) had endometrioid type histology. Sarcopenia was not associated with OS (P = 0.951) or DSS (P = 0.545) However, in multivariate analysis, sarcopenic obesity was associated with reduced OS in endometrioid endometrial cancer (EEC) patients (P = 0.048). Conclusion Sarcopenic obesity is associated with OS in high‐grade EEC patients, while sarcopenia without obesity is not related to OS or DSS in high‐grade EC. In non‐endometrioid endometrial cancer, there is no association between sarcopenic obesity and survival.

The Prognostic Benefit of Early Postoperative Radiotherapy and Diagnostic Value of Serologic Markers on Women with Uterine Sarcoma and Carcinosarcoma

“…While the nutritional status and sarcopenia has been described to have an impact on survival in endometrial cancer [44], this could not be confirmed for the BMI in our cohort of uterine sarcoma. Since the absolute value of a single marker does not always give an indication of the prognosis, we further applied the Nutritional Index that had been previously described to go along with inferior oncologic outcomes in gastrointestinal and lung cancer [27], but neither a prediction of OS nor LC or DC was found.…”

The sarcopenia index measured using the lumber paraspinal muscle is associated with prognosis in endometrial cancer

“…The selection of a muscle for determining the sarcopenia index is very important [21]. Although ideally sarcopenia would be measured in the whole skeletal muscle, in practice this would be too complicated for a clinical setting, because it would require additional software packages, and the Hans eld is very different among patients [16,23,25]. In this study, we selected the psoas, iliac, and paraspinal muscles for calculating the sarcopenia index [22].…”