Prognostic significance of psoas muscle index at diagnosis in cervical cancer progression

초록

Introduction/Background To assess whether the psoas muscle index (PMI) measured using CT at diagnosis can predict cancer progression and overall survival in patients with cervical cancer. Methodology We retrospectively reviewed the medical records of patients diagnosed with cervical cancer between January 2019 and December 2023 at a single tertiary referral centre. Patients with incomplete data or those who were lost to follow-up were excluded. The psoas muscle index (PMI) was derived by measuring the transverse and perpendicular diameters of both psoas muscles at the L3 vertebral level using axial CT images: PMI = (sum of the axial and transverse diameters of both psoas muscles) / height (m)2. A cutoff value of 35 mm/m2 was used to classify patients into low and high PMI groups. Survival outcomes were assessed using Kaplan–Meier analysis and the log-rank test. Cox proportional hazards models were used to identify prognostic factors. Results Of the 178 patients, 92 were in the low PMI group and 86 in the high PMI group. patients with higher PMI values showed significantly prolonged disease-free survival (DFS) (p < 0.001) but not with OS (p = 0.395). In multivariate Cox regression analysis, higher PMI independently predicted a lower likelihood of disease progression (adjusted hazard ratio, 0.30; p < 0.001). However, PMI was not associated with OS. Conclusion This study demonstrates that PMI measured at diagnosis may serve as a useful independent prognostic factor for cancer progression in patients with cervical cancer.