The role of sarcopenic obesity in high-grade endometrial cancer.

Abstract

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. 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 ≤41cm2 /m2 . Sarcopenic obesity was defined as sarcopenia combined with body mass index (BMI) ≥30kg/m2 . A total of 176 patients with median age of 70years and median BMI of 29.4kg/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). 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.