Visceral abdominal fat measured by computer tomography as a prognostic factor for gynecological malignancies?
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Johanna Nattenmüller1,*, Joachim Rom2,*, Tom Buckner3, Jalal Arvin2, Benedikt Bau2,5, Christof Sohn2, Hans-Ulrich Kauczor1 and Sarah Schott2,4
1Department of Diagnostic and Interventional Radiology, University Hospital, Heidelberg, Germany
2Department of Obstetrics and Gynecology, University Hospital, Heidelberg, Germany
3Department of Medical Biometry and Informatics, University Heidelberg, Heidelberg, Germany
4NCT Heidelberg, DKTK Heidelberg, Heidelberg, Germany
5Department of Gynecology and Obstetrics, Regional Hospital Nordjylland, Hjørring, Denmark
*These authors have contributed equally to this work and defined as co-first author
Johanna Nattenmüller, email: [email protected]
Keywords: body composition; BMI; obesity; gynecological malignancies; computed tomography
Received: December 19, 2017 Accepted: February 27, 2018 Published: March 27, 2018
Introduction: Obesity is associated with increased incidence of ovarian (OC), cervical (CC) and endometrium cancer (EC). However, the impact of body composition (BC) on overall survival (OS), especially of visceral adipose tissue (VAT) is not yet understood.
Methods: In 189 women with gynecological malignancies (31 OC, 104 CC, 54 EC, mean age 62.9y; mean BMI 26.8 kg/m2; median follow-up 30.7months) with routine staging CT-scans at baseline (mean interval: 4.3 months), densitometric quantification of total (TAT), visceral, and subcutaneous-fat-area (SAT), inter-muscular-fat-area (IMFA), and skeletal-muscle-index (SMI) was performed to analyze the impact of BC on survival.
Results: With a mean follow-up of 30.7 months 48 patients had died. We observed no significant differences regarding BMI, the adipose- and muscle-distribution between surviving and deceased women. Univariate analyses revealed no significant BC-parameter with impact on OS, which was confirmed by different multivariate models. A subgroup analysis of OC, CC and EC showed only a protective impact of SMI on survival in the subgroup of CC.
Conclusions: Despite the increased incidence of gynecological malignancies in obese, we found no significant impact of BC including VAT on patient survival. Further studies with larger cohorts are needed to quantify BC and its metabolomic impact regarding treatment and prognosis.
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