303P - Prognostic value of body composition and systemic inflammatory markers in patients with locally advanced cervical cancer following chemoradiotherapy

Background

Abnormal changes in body composition and systemic inflammation response have been associated with poor survival of cancer patients. Our study was to explore the prognostic value of the association between body composition indicators and systemic inflammation markers among patients with locally advanced cervical cancer (LACC) who underwent concurrent chemoradiotherapy (CCRT).

Methods

We retrospectively reviewed medical records of LACC patients treated between 2016 and 2019. Subcutaneous, visceral and intra-muscular adipose index (SAI, VAI and IMAI) and skeletal muscle index (SMI) were derived from computed tomography (CT). Kaplan-Meier analysis and Univariate and multivariate Cox analyses were used to evaluate the survival. A nomogram was constructed to assess the prognostic value.

Results

The study included 196 patients treated with CCRT. According to multivariable Cox analyses, IIIC1r (hazard ratio [HR] = 9.69; 95% confidence interval [CI] = 1.05 - 89.22; P = 0.045), high systemic immune-inflammation index (SII) (HR = 7.35; 95% CI = 1.88-28.66; P = 0.004), sarcopenia (HR = 3.6; 95% CI = 1.4 - 9.23; P = 0.008), high SAI (HR = 4.7; 95% CI = 1.33 - 16.66; P = 0.016) and high VAI (HR = 7.53; 95% CI = 2.27 - 25.01; P = 0.001) were significantly risk factors for OS. Kaplan-Meier analysis showed that patients with low lymphocyte-to-monocyte ratio (LMR) and sarcopenia had longer OS than those with high LMR and sarcopenia (p = 0.023). The high neutrophil-to-lymphocyte ratio (NLR) in non-sarcopenic patients showed better survival (p = 0.022). Low VAI (p = 0.019) or low IMAI (p = 0.019) combined with low SII had a favorable OS. Low LMR combined with low SAI was associated with longer OS (p = 0.022). The calibration plots of nomogram predicting the 3-year and 5-year OS rates were close to the ideal models.

Conclusions

The poor body compositions (sarcopenia, high SAI and high VAI) measured by CT scans were associated with survival of LACC patients who underwent CCRT. Inflammation factors were closely associated with abnormal muscle and fat distribution. The combined prognostic value of body composition indicators and systemic inflammation markers was reliable in predicting survival for LACC patients.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

National Natural Science Foundation of China (No.81672591).

Disclosure

All authors have declared no conflicts of interest.