# Relationship between visceral obesity and prognosis in patients with stage IVB cervical cancer receiving radiotherapy and chemotherapy

## TL;DR

Higher visceral obesity before treatment is linked to better survival in stage IVB cervical cancer patients undergoing chemoradiotherapy.

## Contribution

Identifies visceral-to-subcutaneous fat ratio (VSR) as an independent prognostic factor in stage IVB cervical cancer.

## Key findings

- High visceral-to-subcutaneous adipose tissue area ratio (VSR) is associated with significantly higher overall survival rates.
- Low VSR is an independent risk factor for poor prognosis in stage IVB cervical cancer patients.
- Visceral obesity before treatment has a protective effect on patient outcomes.

## Abstract

Concurrent chemoradiotherapy is the preferred treatment for stage IVB cervical cancer; however, some patients experience a poor prognosis. The prognostic significance of body composition indicators, including visceral obesity, has been extensively investigated in patients with cancer. This study aimed to assess the impact of body composition indicators, specifically pretreatment fat content, on the survival outcomes of patients with stage IVB cervical cancer.

We retrospectively analyzed clinical information from patients diagnosed with stage IVB cervical cancer between 2010 and 2018. We measured visceral obesity (visceral-to-subcutaneous adipose tissue area ratio [VSR]) and skeletal muscle index (SMI) on pretreatment computed tomography (CT) images. We evaluated the impact of these body composition parameters on the prognosis of patients with cervical cancer.

Overall, 116 patients were included, 81 of whom had complete clinical and imaging information. Based on the cut-off values from X-tile analysis, we categorized patients into high and low VSR and SMI groups. The overall survival (OS) rate of patients with a high VSR was significantly higher than that of patients with a low VSR (P = 0.022). Multivariate Cox regression analysis showed that a low VSR was an independent risk factor for the prognosis of patients with stage IVB cervical cancer.

Visceral obesity before radiotherapy and chemotherapy has a protective effect on the prognosis of patients with stage IVB cervical cancer, while low muscle index and VSR are associated with poor prognosis.

CI: Confidence interval; SMI: Skeletal muscle index; VSR: Visceral/subcutaneous fat area ratio.Image 1

•In patients with stage IVB cervical cancer, the overall survival (OS) rate of patients with high visceral-to-subcutaneous adipose tissue area ratio (VSR) is significantly higher than those with low VSR.•A low VSR is an independent risk factor for poor prognosis in patients with stage IVB cervical cancer.•Visceral obesity before chemoradiotherapy has a protective effect on the prognosis of patients with stage IVB cervical cancer.

In patients with stage IVB cervical cancer, the overall survival (OS) rate of patients with high visceral-to-subcutaneous adipose tissue area ratio (VSR) is significantly higher than those with low VSR.

A low VSR is an independent risk factor for poor prognosis in patients with stage IVB cervical cancer.

Visceral obesity before chemoradiotherapy has a protective effect on the prognosis of patients with stage IVB cervical cancer.