Pre-operative Assessment of Muscle Mass to Predict Surgical Complications and Prognosis in Patients With Endometrial Cancer

L. M. Kuroki, M. Mangano, J. E. Allsworth, C. O. Menias, L. S. Massad, M. A. Powell, D. G. Mutch, P. H. Thaker

Research output: Contribution to journalArticlepeer-review

87 Scopus citations


Methods: A retrospective review of endometrial cancer patients who underwent surgery between 2005 and 2009 was performed. Sarcopenia was assessed on preoperative computed tomography (CT) scan by measurement of the lumbar psoas muscle cross-sectional area and defined as any value below the median (<4.33 cm2). Sarcopenic obesity was defined as sarcopenia plus a body mass index (BMI) of 30 kg/m2 or higher. Microsatellite instability (MSI) was analyzed using the National Cancer Institute (NCI) consensus markers and tumor from hysterectomy specimens.

Conclusions: Sarcopenia has an impact on recurrence-free survival, but does not appear to have a negative impact on surgical outcomes or overall survival among endometrial cancer patients who undergo preoperative CT scan.

Results: Of 122 patients, 27 (22 %) met the criteria for sarcopenic obesity. Sarcopenic patients were older than patients with normal muscle mass (mean age, 69.7 vs. 62.1 years; p < 0.001), had a lower BMI (31.1 vs. 39.4 kg/m2; p < 0.001), and had more comorbidities (p = 0.048). Sarcopenia was not associated with tumor MSI, hospital stay, 90-day readmission rate, or early/late complications. Patients with sarcopenia had a shorter recurrence-free survival than nonsarcopenic patients (median 23.5 vs. 32.1 months; log-rank p = 0.02), but did not differ in terms of overall survival (log-rank p = 0.25). After adjustment for race, BMI, lymphocyte count, and tumor histology, sarcopenia was associated with a fourfold shorter recurrence-free survival (adjusted hazard ratio [HRadj], 3.99; 95 % confidence interval [CI], 1.42–11.3).

Background: Sarcopenia or loss of skeletal muscle mass is an objective measure of frailty associated with functional impairment and disability. This study aimed to examine the impact of sarcopenia on surgical complications and survival outcomes in patients with endometrial cancer.

Original languageEnglish
Pages (from-to)972-979
Number of pages8
JournalAnnals of Surgical Oncology
Issue number3
StatePublished - 2015


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