Adverse effect of excess body weight on survival in cervical cancer patients after surgery and radiotherapy

Abstract

PurposeThis study aimed to assess the effects of body mass index (BMI) on survival in cervical cancer patients who had undergone surgery and radiotherapy (RT).Materials and MethodsWe retrospectively reviewed the medical records of 70 cervical cancer patients who underwent surgery and RT from 2007 to 2012. Among them, 40 patients (57.1%) had pelvic lymph node metastases at the time of diagnosis. Sixty-seven patients (95.7%) had received chemotherapy. All patients had undergone surgery and postoperative RT. Median BMI of patients was 22.8 kg/m2 (range, 17.7 to 35.9 kg/m2).ResultsThe median duration of follow-up was 52.3 months (range, 16 to 107 months). Twenty-four patients (34.3%) showed recurrence. Local failure, regional lymph nodal failure, and distant failure occurred in 4 (5.7%), 6 (8.6%), and 17 (24.3%) patients, respectively. The 5-year actuarial pelvic control rate was 83.4%. The 5-year cancer-specific survival (CSS) and disease-free survival (DFS) rates were 85.1% and 65.0%, respectively. The presence of pelvic lymph node metastases (n = 30) and being overweight or obese (n = 34, BMI ≥ 23 kg/m2) were poor prognostic factors for CSS (p = 0.003 and p = 0.045, respectively). Of these, pelvic lymph node metastasis was an independent prognostic factor (p = 0.030) for CSS.ConclusionOverweight or obese cervical cancer patients showed poorer survival outcomes than normal weight or underweight patients. Weight control seems to be important in cervical cancer patients to improve clinical outcomes.

Prognostic Significance of Sarcopenia With Inflammation in Patients With Head and Neck Cancer Who Underwent Definitive Chemoradiotherapy

“…Patients with head and neck cancer may experience progressive weight loss following their diagnosis; significant weight loss is associated with poorer overall survival (OS) ( 1 , 2 ). The prognoses of these patients can be influenced in part by changes in body composition and loss of body weight ( 3 ). Cancer cachexia is related to the activation of systemic inflammatory responses as well as imbalances in energy intake and expenditure over the disease course and during treatment.…”

Patients with cervical cancer without visceral obesity had better treatment outcomes

“…Our study determined the relationship between visceral obesity and treatment outcomes among patients with cervical cancer. Previous studies have examined the association of obesity, measured by BMI, and cancer risk (3)(4)(5). Specifically, a previous study conducted a meta-analysis to explore the association between BMI and cervical cancer risk (4); the study concluded that overweight is not associated with an increased risk of cervical cancer, but obesity is mildly associated with an increased risk of cervical cancer.…”

“…However, whether obesity may affect cancer incidence is relatively inconclusive. In addition, Choi et al assessed the effect of BMI on the outcomes of cervical cancer patients (5). They concluded that overweight or obese (BMI ≥23 kg/m 2 ) patients with cervical cancer had poorer 5-year cancer-specific survival than did other patients.…”

“…Studies have examined the relationship between obesity [mostly measured by body mass index (BMI)] and cancer risk and treatment outcomes (3)(4)(5). A meta-analysis revealed that obesity is mildly associated with an increased risk of cervical cancer (4).…”

Factors Associated With Radiation Treatment Compliance for Women With Cervical Cancer in a Safety Net Health System

“…This is consistent with other series both in rectal cancer and cervical cancer. 32,33 This correlation may be related to difficulties associated with surgical resection and lymphatic dissection, radiation dose distributions, patient positioning for external beam, and brachytherapy applicator positioning.…”