Sarcopenia And Endometrial Cancer Prognosis

Camila RODRIGUES, Brazilian National Cancer Institute, Brazil

1 Department of Nutrition and Dietetics, Brazilian National Cancer Institute, Brazil.

Purposes: Sarcopenia has been recently recognized as an important risk factor for high mortality and surgical complications in cancer patients. Estimation of the cross-sectional muscle area measured by computed tomography scans provides a quick and easy way to identify patients at higher risks of worst outcomes. The association between sarcopenia and short term survival has never been demonstrated in endometrial cancer (EC) patients. The aim of the present study was to investigate the prevalence of sarcopenia and its impact on both short and long-term outcomes among patients undergoing oncological treatment for EC.
Methods: a database was created, comprising EC patients who underwent oncological treatment at Brazilian National Cancer Institute between 2008 and 2014 and had a CT scan available within 30 days before treatment. Clinicopathological features, surgical outcomes and one-year survival were retrospectively collected from medical records. The skeletal muscle index was measured on the CT scans was calculated to identify sarcopenia. Multivariate logistic regression were calculated to assess predictors of surgical complications. One-year survival were evaluated by Kaplan-Meier method and Cox Regression. Variables were considered statistical significant when p<0.05.
Results: 212 women with EC were included. Median age was 65 years-old, and 26.4% patients were diagnosed with sarcopenia. 47.2% of those who had sarcopenia were overweight according body mass index (> 25Kg/m2) and therefore classified as sarcopenic obesity. Sarcopenia and sarcopenic obesity were independent predictors of surgical complications. Sarcopenia was also associated with 30-day and one-year mortality. The average one-year survival of women with sarcopenia was 209.3 days (95% CI 168.757 to 249.861) versus 307.6 days for women without sarcopenia (IC 289.217 to 325.907). After ajustment, sarcopenia were an independent predictor of one-year survival in EC patients.
Conclusions: Sarcopenia is an independent prognosis factor in EC patients and should be assessed whenever possible to support early nutritional intervention.