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Purpose <p>This study investigates the link between CT-measured fat area and patient outcomes following chemoradiotherapy for locally advanced cervical cancer. It assesses the reliability of CT fat area as a prognostic indicator.</p> Methods <p>The retrospective study included 129 cervical cancer patients with over 36 months of follow-up. All underwent abdominal CT and pelvic MRI before treatment. Clinical factors (age, BMI, tumor stage, pathology) were recorded. Fat areas—total (TFA), visceral (VFA), and subcutaneous (SFA)—were measured at the L3-L4 level via CT. MRI evaluated tumor size, parametrial invasion, lymph node score, and tumor extension to adjacent organs. The study’s endpoints were tumor progression and mortality, with progression-free survival (PFS) and overall survival (OS) determined using Kaplan-Meier method and compared with the Log-rank test. A Cox model analyzed the impact of clinical and imaging variables on survival.</p> Results <p>Patients with TFA ≤ 150&#xa0;cm² or &gt; 300&#xa0;cm² experienced poorer PFS and OS compared to those with 150&#xa0;cm² &lt; TFA ≤ 300&#xa0;cm². VFA ≤ 70&#xa0;cm² correlated with worse OS, and SFA &gt; 200&#xa0;cm² with poorer PFS. In univariable analysis, significant factors included pathology type, parametrial invasion, lymph node score, and tumor extension (all <i>p</i> &lt; 0.05). Multivariable analysis identified ultra-low/high TFA and high lymph node score as independent predictors of poor PFS and OS.</p> Conclusion <p>Abdominal fat area, measured by CT, is significantly associated with disease prognosis in cervical cancer. Both ultra-low and ultra-high fat areas indicate worse outcomes, suggesting that CT measurements could be a reliable predictive tool for disease outcomes.</p>

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Can abdominal CT measured fat area be a predictor of outcome in cervical cancer after chemoradiotherapy?

  • 期刊论文

  • 发表日期：

    2025年8月22日

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  • Ya-fei Qi,
  • Ling Yuan,
  • Hua-dan Xue,
  • Yong-lan He,
  • Yang Xiang,
  • Zheng-yu Jin

摘要

Purpose

This study investigates the link between CT-measured fat area and patient outcomes following chemoradiotherapy for locally advanced cervical cancer. It assesses the reliability of CT fat area as a prognostic indicator.

Methods

The retrospective study included 129 cervical cancer patients with over 36 months of follow-up. All underwent abdominal CT and pelvic MRI before treatment. Clinical factors (age, BMI, tumor stage, pathology) were recorded. Fat areas—total (TFA), visceral (VFA), and subcutaneous (SFA)—were measured at the L3-L4 level via CT. MRI evaluated tumor size, parametrial invasion, lymph node score, and tumor extension to adjacent organs. The study’s endpoints were tumor progression and mortality, with progression-free survival (PFS) and overall survival (OS) determined using Kaplan-Meier method and compared with the Log-rank test. A Cox model analyzed the impact of clinical and imaging variables on survival.

Results

Patients with TFA ≤ 150 cm² or > 300 cm² experienced poorer PFS and OS compared to those with 150 cm² < TFA ≤ 300 cm². VFA ≤ 70 cm² correlated with worse OS, and SFA > 200 cm² with poorer PFS. In univariable analysis, significant factors included pathology type, parametrial invasion, lymph node score, and tumor extension (all p < 0.05). Multivariable analysis identified ultra-low/high TFA and high lymph node score as independent predictors of poor PFS and OS.

Conclusion

Abdominal fat area, measured by CT, is significantly associated with disease prognosis in cervical cancer. Both ultra-low and ultra-high fat areas indicate worse outcomes, suggesting that CT measurements could be a reliable predictive tool for disease outcomes.