S478
Clinical - Gynaecological
ESTRO 2026
(EC). Material/Methods:
p=0,01). Upon analyzing sarcopenia measured at L3 and the obesity index in our series, patients with SMI <39 had a 44% obesity rate compared to 34% in patients with adequate muscle mass. SMI did not show any influence on OS, LRFS, PRFS, or MFRS. However, in patients with SMI >39 (well nourished), there were differences with a trend toward significance between higher
Between January 2020 and July 2025, 90 patients with EC underwent adjuvant RT in our department, and 62 of them received external radiotherapy. Mean age was 67 years (range 44-91). Clinical, pathological, and treatment characteristics are detailed in Figure 1.
risk of metastases and obesity (BMI >30).Neither SMI nor BMI showed a
correlation with urinary or intestinal adverse effects. We only observed a trend toward a higher risk of proctitis in patients with SMI <39 (8.7% vs 0%, p = 0.06). We observed a proctitis-free survival rate of 90% in SMI <39 vs. 100% in SMI >39 (p = 0.02). Figure 2
Related to nutrition, SMI was calculated from pre-treatment CT scans at the L3 level and normalized for height (cm ² /m ² ). Patients were stratified into low (<39), and normal (>39), SMI groups based on sex-specific cut-offs. Low SMI indicates sarcopenia, and high SMI indicates adequate muscle mass. Additionally, Body Mass Index, BMI, was studied, dividing the patients into normal/overweight (<30) and obesity (>30).Treatment-related acute and late adverse effects were recorded according to CTCAE v5.0 criteria. The impact of SMI, BMI, pathological stage, grade, and molecular subtype on local relapse, metastases, and overall survival was analyzed.Statistical analysis: Kaplan–Meier method, log-rank test, and Chi-square test. Results: After a median follow-up of 4 months (6-63), 2-year overall survival (OS), local relapse free- survival (LRFS), pelvic relapse free-survival (PRFS) and metastasis free survival (MFRS) rates were 98,4%, 98.6%, 92.2%, and 81.8%, respectively. PRFS was worse in grade 3 vs grade 1-2 tumors (89,8% vs 100%, p=0,03). PRFS was also significantly lower in p53- mutated vs. wild-type tumors (83,1% vs 100%,
Conclusion: SMI and BMI showed no significant impact on OS, LRFS, PRFS, or MFRS. However, a trend towards higher metastasis risk was observed in patients with SMI >39 and obesity. Additionally, lower SMI was associated with a higher risk of proctitis. References: Bastijns S, et al. The influence of muscle morphology on oncological outcomes: a review. J Frailty Sarcopenia Falls. 2025 Sep 1;10(3):163-199. doi: 10.22540/JFSF-10-163. PMID: 40901339; PMCID: PMC12401225.Lee J, Lin J-B, Wu M-H, et al. Muscle radiodensity loss during cancer therapy is predictive for poor survival in advanced endometrial cancer. J Cachexia Sarcopenia Muscle. 2019;10(4):814-826. doi: 10.1002/jcsm.12440.Aprile G, Basile D, Giaretta R, Schiavo G, La Verde N, Corradi E,
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