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938 Is temporal change in abdominal fat distribution related to endometrial cancer prognosis?
  1. Kristine E Fasmer1,
  2. Jostein Sæterstøl1,
  3. Maria Beate Svanes Ljunggren1,
  4. Astrid Marie Kirkesæther Brun1,
  5. Johanna MA Pijnenborg2,
  6. Camilla Krakstad3 and
  7. Ingfrid S Haldorsen1
  1. 1Mohn Medical Imaging and Visualization Center (MMIV), Department of Radiology, Haukeland University Hospital, Bergen, Norway
  2. 2Radboud University Medical Center, Nijmegen, The Netherlands
  3. 3Department of Obstetrics and Gynecology, Haukeland University Hospital, Bergen, Norway


Introduction/Background The objectives of this study was to quantify abdominal obesity markers from computed tomography (CT) scans at primary diagnosis and follow-up in a large endometrial cancer cohort, and to assess temporal change in obesity markers in relation to clinical phenotype and outcome.

Methodology Total- (TAV), subcutaneous- (SAV), visceral abdominal fat volumes (VAV), and visceral-to-total fat percentage (VAV%) were derived in an endometrial cancer patient cohort with CT scans acquired at primary diagnosis (n_primary=293). Temporal (delta, δ) changes in CT obesity markers from primary diagnosis to follow-up were assessed for all patients with a follow-up CT 13 (7, 19) [median (interquartile range)] months after diagnosis (n_follow-up=152/293 patients). The CT obesity markers were assessed in relation to clinicopathological patient features and progression free survival (PSF) using Mann-Whitney U-test, and Cox hazard ratios (HRs), respectively.

Results At primary diagnosis, patients with high-risk histology (endometrioid (EEC) grade 3/non-endometrioid (NEEC)) had significantly lower TAV, SAV, and body mass index (p≤0.03), while higher VAV% (p=0.005) than patients with low-risk histology (EEC grade 1–2). High VAV% (≥36%) predicted poor PFS both in univariable analysis (HR=2.4, p=0.04), and when stratified for surgicopathological FIGO stage (HR=2.8, p=0.02). At follow-up, median TAV, VAV, SAV, and VAV% were significantly lower than at primary diagnosis (p<0.001 for all). Furthermore, patients with progression had larger reductions in visceral fat compartments (δVAV=-25%, δVAV% =-4%), than patients with no progression (δVAV=-17%, δVAV/TAV=-2%, p≤0.006 for both). Additionally, δVAV%≤-4% predicted poor PFS both in univariable analysis (HR=2.5, p<0.001) and when stratified for FIGO stage (HR=2.0, p=0.03).

Conclusion Abdominal fat distribution markers from preoperative abdominal CT predict endometrial cancer prognosis, and higher visceral fat loss during/following therapy is associated with disease progression.

Disclosures The authors have no conflicts of interest to disclose.

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