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

초록

Objective: To assess whether the psoas muscle index (PMI) measured using computed tomography (CT) at diagnosis can predict cancer progression and overall survival (OS) in patients with cervical cancer. Methods: We retrospectively reviewed the medical records of patients diagnosed with cervical cancer at Korea University Anam Hospital from January 2019 to December 2023. Patients with incomplete data or those who were lost to follow-up were excluded. PMI was measured on axial CT images at the third lumbar vertebral (L3) level at diagnosis, defined as the sum of bilateral psoas diameters normalized to height squared (m(2)), and a cutoff value of 35 mm/m(2) 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. Higher PMI was associated with 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, particularly for predicting DFS.

키워드