Impact of Computed Tomography-Based, Artificial Intelligence-Driven Volumetric Sarcopenia on Survival Outcomes in Early Cervical Cancer
被引:15
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作者:
Han, Qingling
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Seoul Natl Univ, Dept Obstet & Gynecol, Coll Med, Seoul, South KoreaSeoul Natl Univ, Dept Obstet & Gynecol, Coll Med, Seoul, South Korea
Han, Qingling
[1
]
Kim, Se Ik
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Seoul Natl Univ, Dept Obstet & Gynecol, Coll Med, Seoul, South KoreaSeoul Natl Univ, Dept Obstet & Gynecol, Coll Med, Seoul, South Korea
Kim, Se Ik
[1
]
Yoon, Soon Ho
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机构:
UMass Mem Med Ctr, Dept Radiol, Worcester, MA USA
Seoul Natl Univ, Dept Radiol, Coll Med, Seoul, South KoreaSeoul Natl Univ, Dept Obstet & Gynecol, Coll Med, Seoul, South Korea
Yoon, Soon Ho
[2
,3
]
Kim, Taek Min
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Seoul Natl Univ, Dept Radiol, Coll Med, Seoul, South KoreaSeoul Natl Univ, Dept Obstet & Gynecol, Coll Med, Seoul, South Korea
Kim, Taek Min
[3
]
Kang, Hyun-Cheol
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Seoul Natl Univ, Dept Radiat Oncol, Coll Med, Seoul, South KoreaSeoul Natl Univ, Dept Obstet & Gynecol, Coll Med, Seoul, South Korea
Kang, Hyun-Cheol
[4
]
Kim, Hak Jae
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Seoul Natl Univ, Dept Radiat Oncol, Coll Med, Seoul, South KoreaSeoul Natl Univ, Dept Obstet & Gynecol, Coll Med, Seoul, South Korea
Kim, Hak Jae
[4
]
Cho, Jeong Yeon
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Seoul Natl Univ, Dept Radiol, Coll Med, Seoul, South KoreaSeoul Natl Univ, Dept Obstet & Gynecol, Coll Med, Seoul, South Korea
Cho, Jeong Yeon
[3
]
Kim, Jae-Weon
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Seoul Natl Univ, Dept Obstet & Gynecol, Coll Med, Seoul, South KoreaSeoul Natl Univ, Dept Obstet & Gynecol, Coll Med, Seoul, South Korea
Kim, Jae-Weon
[1
]
机构:
[1] Seoul Natl Univ, Dept Obstet & Gynecol, Coll Med, Seoul, South Korea
[2] UMass Mem Med Ctr, Dept Radiol, Worcester, MA USA
[3] Seoul Natl Univ, Dept Radiol, Coll Med, Seoul, South Korea
[4] Seoul Natl Univ, Dept Radiat Oncol, Coll Med, Seoul, South Korea
The purpose of this study was to investigate the impact of sarcopenia and body composition change during primary treatment on survival outcomes in patients with early cervical cancer. We retrospectively identified patients diagnosed with 2009 International Federation of Gynecology and Obstetrics stage IB1-IIA2 cervical cancer who underwent primary radical hysterectomy between 2007 and 2019. From pre-treatment CT scans (n = 306), the skeletal muscle area at the third lumbar vertebra (L3) and the waist skeletal muscle volume were measured using an artificial intelligence-based tool. These values were converted to the L3 and volumetric skeletal muscle indices by normalization. We defined L3 and volumetric sarcopenia using 39.0 cm(2)/m(2) and the first quartile (Q1) value, respectively. From pre- and post-treatment CT scan images (n = 192), changes (%) in waist skeletal muscle and fat volumes were assessed. With the use of Cox regression models, factors associated with progression-free survival (PFS) and overall survival (OS) were analyzed. Between the L3 sarcopenia and non-sarcopenia groups, no differences in PFS and OS were observed. In contrast, volumetric sarcopenia was identified as a poor prognostic factor for PFS (adjusted hazard ratio [aHR], 1.874; 95% confidence interval [CI], 1.028-3.416; p = 0.040) and OS (aHR, 3.001; 95% CI, 1.016-8.869; p = 0.047). During primary treatment, significant decreases in waist skeletal muscle (median, -3.9%; p < 0.001) and total fat (median, -5.3%; p < 0.001) were observed. Of the two components, multivariate analysis revealed that the waist fat gain was associated with worse PFS (aHR, 2.007; 95% CI, 1.009-3.993; p = 0.047). The coexistence of baseline volumetric sarcopenia and waist fat gain further deteriorated PFS (aHR, 2.853; 95% CI, 1.257-6.474; p = 0.012). In conclusion, baseline volumetric sarcopenia might be associated with poor survival outcomes in patients with early cervical cancer undergoing primary RH. Furthermore, sarcopenia patients who gained waist fat during primary treatment were at a high risk of disease recurrence.</p>
机构:
Seoul Natl Univ, Dept Obstet & Gynecol, Coll Med, 101 Daehak Ro, Seoul 03080, South KoreaSeoul Natl Univ, Dept Obstet & Gynecol, Coll Med, 101 Daehak Ro, Seoul 03080, South Korea
Kim, Se Ik
Chung, Joo Yeon
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Seoul Natl Univ, Dept Obstet & Gynecol, Coll Med, 101 Daehak Ro, Seoul 03080, South KoreaSeoul Natl Univ, Dept Obstet & Gynecol, Coll Med, 101 Daehak Ro, Seoul 03080, South Korea
Chung, Joo Yeon
Paik, Haerin
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Seoul Natl Univ, Dept Obstet & Gynecol, Coll Med, 101 Daehak Ro, Seoul 03080, South KoreaSeoul Natl Univ, Dept Obstet & Gynecol, Coll Med, 101 Daehak Ro, Seoul 03080, South Korea
Paik, Haerin
Seol, Aeran
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Seoul Natl Univ, Dept Obstet & Gynecol, Coll Med, 101 Daehak Ro, Seoul 03080, South KoreaSeoul Natl Univ, Dept Obstet & Gynecol, Coll Med, 101 Daehak Ro, Seoul 03080, South Korea
Seol, Aeran
Yoon, Soon Ho
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机构:
Seoul Natl Univ, Dept Radiol, Coll Med, Seoul 03080, South Korea
UMass Mem Med Ctr, Dept Radiol, Worcester, MA 01605 USASeoul Natl Univ, Dept Obstet & Gynecol, Coll Med, 101 Daehak Ro, Seoul 03080, South Korea
Yoon, Soon Ho
Kim, Taek Min
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Seoul Natl Univ, Dept Radiol, Coll Med, Seoul 03080, South KoreaSeoul Natl Univ, Dept Obstet & Gynecol, Coll Med, 101 Daehak Ro, Seoul 03080, South Korea
Kim, Taek Min
Kim, Hee Seung
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Seoul Natl Univ, Dept Obstet & Gynecol, Coll Med, 101 Daehak Ro, Seoul 03080, South KoreaSeoul Natl Univ, Dept Obstet & Gynecol, Coll Med, 101 Daehak Ro, Seoul 03080, South Korea
Kim, Hee Seung
Chung, Hyun Hoon
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Seoul Natl Univ, Dept Obstet & Gynecol, Coll Med, 101 Daehak Ro, Seoul 03080, South KoreaSeoul Natl Univ, Dept Obstet & Gynecol, Coll Med, 101 Daehak Ro, Seoul 03080, South Korea
Chung, Hyun Hoon
Cho, Jeong Yeon
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Seoul Natl Univ, Dept Radiol, Coll Med, Seoul 03080, South KoreaSeoul Natl Univ, Dept Obstet & Gynecol, Coll Med, 101 Daehak Ro, Seoul 03080, South Korea
Cho, Jeong Yeon
Kim, Jae-Weon
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Seoul Natl Univ, Dept Obstet & Gynecol, Coll Med, 101 Daehak Ro, Seoul 03080, South KoreaSeoul Natl Univ, Dept Obstet & Gynecol, Coll Med, 101 Daehak Ro, Seoul 03080, South Korea
Kim, Jae-Weon
Lee, Maria
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Seoul Natl Univ, Dept Obstet & Gynecol, Coll Med, 101 Daehak Ro, Seoul 03080, South Korea
Seoul Natl Univ Hosp, Dept Obstet & Gynecol, Seoul 03080, South KoreaSeoul Natl Univ, Dept Obstet & Gynecol, Coll Med, 101 Daehak Ro, Seoul 03080, South Korea
机构:
Med Univ Vienna, Div Gastroenterol & Hepatol, Intemal Med 3, Vienna, AustriaMed Univ Vienna, Div Gastroenterol & Hepatol, Intemal Med 3, Vienna, Austria
Paternostro, Rafael
Lampichler, Katharine
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Med Univ Vienna, Dept Biomed Imaging & Image Guided Therapy, Vienna, AustriaMed Univ Vienna, Div Gastroenterol & Hepatol, Intemal Med 3, Vienna, Austria
Lampichler, Katharine
Bardach, Constanze
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Med Univ Vienna, Dept Biomed Imaging & Image Guided Therapy, Vienna, AustriaMed Univ Vienna, Div Gastroenterol & Hepatol, Intemal Med 3, Vienna, Austria
Bardach, Constanze
Asenbaum, Ulrike
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Med Univ Vienna, Dept Biomed Imaging & Image Guided Therapy, Vienna, AustriaMed Univ Vienna, Div Gastroenterol & Hepatol, Intemal Med 3, Vienna, Austria
Asenbaum, Ulrike
Landler, Clara
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Med Univ Vienna, Div Gastroenterol & Hepatol, Intemal Med 3, Vienna, AustriaMed Univ Vienna, Div Gastroenterol & Hepatol, Intemal Med 3, Vienna, Austria
Landler, Clara
Mandorferl, Mettles
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Med Univ Vienna, Div Gastroenterol & Hepatol, Intemal Med 3, Vienna, AustriaMed Univ Vienna, Div Gastroenterol & Hepatol, Intemal Med 3, Vienna, Austria
Mandorferl, Mettles
Schwarzer, Remy
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Med Univ Vienna, Div Gastroenterol & Hepatol, Intemal Med 3, Vienna, AustriaMed Univ Vienna, Div Gastroenterol & Hepatol, Intemal Med 3, Vienna, Austria
Schwarzer, Remy
Reiberger, Thomas
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Med Univ Vienna, Div Gastroenterol & Hepatol, Intemal Med 3, Vienna, AustriaMed Univ Vienna, Div Gastroenterol & Hepatol, Intemal Med 3, Vienna, Austria
Reiberger, Thomas
Trauner, Michael H.
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Med Univ Vienna, Div Gastroenterol & Hepatol, Intemal Med 3, Vienna, AustriaMed Univ Vienna, Div Gastroenterol & Hepatol, Intemal Med 3, Vienna, Austria
Trauner, Michael H.
Ferlitsch, Arnulf
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Krankenhaus Barmherzige Bruder, Div Internal Med 2, Vienna, AustriaMed Univ Vienna, Div Gastroenterol & Hepatol, Intemal Med 3, Vienna, Austria
机构:
UCLA, David Geffen Sch Med, 100 Med Plaza, Suite 545, Los Angeles, CA 90024 USAUCLA, David Geffen Sch Med, 100 Med Plaza, Suite 545, Los Angeles, CA 90024 USA
Xia, Jeffrey
Bachour, Kinan
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UCLA, David Geffen Sch Med, 100 Med Plaza, Suite 545, Los Angeles, CA 90024 USAUCLA, David Geffen Sch Med, 100 Med Plaza, Suite 545, Los Angeles, CA 90024 USA
Bachour, Kinan
Suleiman, Abdul-Rahman M.
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UCLA, David Geffen Sch Med, 100 Med Plaza, Suite 545, Los Angeles, CA 90024 USAUCLA, David Geffen Sch Med, 100 Med Plaza, Suite 545, Los Angeles, CA 90024 USA
Suleiman, Abdul-Rahman M.
Roberts, Jacob S.
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UCLA, David Geffen Sch Med, 100 Med Plaza, Suite 545, Los Angeles, CA 90024 USAUCLA, David Geffen Sch Med, 100 Med Plaza, Suite 545, Los Angeles, CA 90024 USA
Roberts, Jacob S.
Sayed, Sammy
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UCLA, David Geffen Sch Med, 100 Med Plaza, Suite 545, Los Angeles, CA 90024 USAUCLA, David Geffen Sch Med, 100 Med Plaza, Suite 545, Los Angeles, CA 90024 USA
Sayed, Sammy
Cho, Geoffrey W.
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UCLA, David Geffen Sch Med, 100 Med Plaza, Suite 545, Los Angeles, CA 90024 USA
Cardiovasc Res Fdn Southern Calif, Beverly Hills, CA 90210 USAUCLA, David Geffen Sch Med, 100 Med Plaza, Suite 545, Los Angeles, CA 90024 USA