Details

Autor(en) / Beteiligte

• Eide, Agnes J.
• Halle, Mari K.
• Lura, Njål
• Fasmer, Kristine E.
• Wagner-Larsen, Kari
• Forsse, David
• Bertelsen, Bjørn I.
• Salvesen, Øyvind
• Krakstad, Camilla
• Haldorsen, Ingfrid S.

Titel

Visceral fat percentage for prediction of outcome in uterine cervical cancer

Ist Teil von

• Gynecologic oncology, 2023-09, Vol.176, p.62-68

Ort / Verlag

United States: Elsevier Inc

Erscheinungsjahr

2023

Quelle

Access via ScienceDirect (Elsevier)

Beschreibungen/Notizen

• [Display omitted] The prognostic role of adiposity in uterine cervical cancer (CC) is largely unknown. Abdominal fat distribution may better reflect obesity than body mass index. This study aims to describe computed tomography (CT)-assessed abdominal fat distribution in relation to clinicopathologic characteristics, survival, and tumor gene expression in CC. The study included 316 CC patients diagnosed during 2004–2017 who had pre-treatment abdominal CT. CT-based 3D segmentation of total-, subcutaneous- and visceral abdominal fat volumes (TAV, SAV and VAV) allowed for calculation of visceral fat percentage (VAV% = VAV/TAV). Liver density (LD) and waist circumference (at L3/L4-level) were also measured. Associations between CT-derived adiposity markers, clinicopathologic characteristics and disease-specific survival (DSS) were explored. Gene set enrichment of primary tumors were examined in relation to fat distribution in a subset of 108 CC patients. High TAV, VAV and VAV% and low LD were associated with higher age (≥44 yrs.; p ≤ 0.017) and high International Federation of Gynecology and Obstetrics (FIGO) (2018) stage (p ≤ 0.01). High VAV% was the only CT-marker predicting high-grade histology (p = 0.028), large tumor size (p = 0.016) and poor DSS (HR 1.07, p < 0.001). Patients with high VAV% had CC tumors that exhibited increased inflammatory signaling (false discovery rate [FDR] < 5%). High VAV% is associated with high-risk clinical features and predicts reduced DSS in CC patients. Furthermore, patients with high VAV% had upregulated inflammatory tumor signaling, suggesting that the metabolic environment induced by visceral adiposity contributes to tumor progression in CC. •Visceral fat predominance is associated with poor survival in cervical cancer.•Visceral fat percentage ≥ 29 is linked to large tumor size and high-grade histology.•Tumors arising in visceral adiposity exhibit increased inflammatory signaling.•Assessing abdominal fat compartments by CT is both feasible and reliable.