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EPV077/#472 Clinical implications of computed tomography-based, artificial intelligence-driven sarcopenia and body composition change during primary treatment in early cervical cancer
  1. SI Kim,
  2. Q Han,
  3. M Lee and
  4. J-W Kim
  1. Seoul National University College of Medicine, Department of Obstetrics and Gynecology, Seoul, Korea, Republic of


Objectives To investigate the impact of sarcopenia and body composition on survival outcomes in patients with early-stage cervical cancer.

Methods We retrospectively analyzed patients diagnosed with 2009 FIGO stage IB1-IIA2 cervical cancer who underwent primary radical hysterectomy between 2007 and 2019. Using an artificial intelligence-based tool, the skeletal muscle area (cm2) at the third lumbar vertebra (L3) and the skeletal muscle volume (cm3) at the waist level were measured from pre-treatment CT scans. These were converted to the L3 and volumetric skeletal muscle indices (SMIs) by normalization. We defined L3 and volumetric sarcopenia using 39.0 cm2/m2 and the first quartile value, respectively. Patients’ survival outcomes were compared according to the presence of sarcopenia.

Results A total of 306 patients were included. Between the L3 sarcopenia and non-sarcopenia groups, no differences in progression-free survival (PFS) and overall survival (OS) were observed. In contrast, the volumetric sarcopenia (n=76) showed significantly worse PFS (P=0.039) and OS (P=0.031) than did the volumetric non-sarcopenia group (n=230). In multivariate analyses, volumetric sarcopenia was identified as a poor prognostic factor for PFS (aHR, 1.872; 95% CI, 1.026–3.415; P=0.041) and OS (aHR, 3.172; 95% CI, 1.058–9.512; P=0.039). Regarding changes in body composition, initial volumetric sarcopenia with total fat gain during primary treatment was associated with worse PFS (aHR, 3.015; 95% CI, 1.314–6.919; P=0.009), but not OS (P=0.070).

Conclusions Volumetric sarcopenia increased the recurrence and mortality rates in patients with early cervical cancer. Patients with initial volumetric sarcopenia and total fat gain during primary treatment were at a high risk of disease recurrence.

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