S424
Clinical - Gynaecological
ESTRO 2026
locally advanced cervical cancer (EMBRACE-I). Lancet Oncol. 2021 Apr;22(4):538–47. 3 - Lindegaard JC, et al. Impact of Patient Selection on Real-World Outcomes by Using the EMBRACE-II Treatment Protocol in Locally Advanced Cervical Cancer. International Journal of Radiation Oncology*Biology*Physics. 2025 Nov;123(3):669–80. Keywords: cervical cancer, induction chemotherapy Sarcopenic obesity in locally advanced cervical cancer: the hidden prognostic impact of body composition Raouia Ben Amor 1,2 , Syrine Lahiouel 1,2 , Raja Oueslati 1 , Zeineb Naimi 1,2 , Roua Toumi 1 , Ghada Bouguerra 1 , Rihab Haddad 1 , Lotfi Kochbati 1,2 1 Radiation Oncology, Abderrahmen Mami Hospital, Ariana, Tunisia. 2 Faculty of medicine of Tunis, Tunis El Manar University, Tunis, Tunisia Digital Poster 1442
the L3 Skeletal Muscle Index (SMI = cm ² /m ² ). Sarcopenia was defined as L3 SMI < 38.5 cm ² /m ² and obesity as BMI ≥ 30 kg/m ² . Associations between body composition and clinical parameters were analyzed using χ² , while correlations were tested using Pearson’s coefficient. Survival outcomes were estimated using Kaplan– Meier and Cox regression models. Results: Median follow-up was 33 months. Mean BMI and L3 SMI were 29.0 kg/m ² and 12.6 cm ² /m ² , respectively. Sarcopenia and obesity were observed in 95.2% and 38.7% of patients, with sarcopenic obesity in 33.9%. (Figure 1).
Strong positive correlations were found between L3 muscle area, FFM, and SMI (r = 0.94–1.00, p<0.001), while sarcopenic obesity was inversely correlated with these parameters (p<0.01). (Table 1 )Table 1. Correlation between body composition parameters and sarcopenic obesity statusVariableMean (±SD)Correlation with Sarcopenic Obesity (r)p-valueL3 Muscle Area (cm ² )31.3 ± 8.2–0.340.009Fat-Free Mass (kg)15.4 ± 2.5–0.340.009L3 SMI (cm ² /m ² )12.6 ± 3.4–0.380.003At 3 years, OS was 65% vs 49% for obese and non-obese patients (p = 0.29), 60% vs 100% for sarcopenic vs non- sarcopenic, and 28% vs 57% for sarcopenic- obese vs obese-only (p = 0.003). (Figue 2)
Purpose/Objective: Sarcopenic obesity, defined as the
coexistence of low skeletal muscle mass and excess adiposity, has emerged as a negative prognostic factor in several malignancies. Its clinical significance in locally advanced cervical cancer (LACC) remains unclear. This study aimed to evaluate the prevalence and prognostic impact of sarcopenic obesity in this population. Material/Methods: Between January 2020 and May 2024, 60 LACC patients treated with VMAT-based CRT (45 Gy/25 fx ± nodal SIB 59.4 Gy) and concurrent weekly cisplatin were analyzed.Median age was 58 years [30 – 83]. FIGO 2009 and 2018 stage distribution was as follows: IIA 1-2 (12.3%), II B(35.4%), III A-B (3%), III C 1-2 (35,3%) and IVA (13,8%). CT images at the L3 vertebral level were used to quantify skeletal muscle area and calculate
In multivariate analysis, sarcopenic obesity
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