The cachexia index as a prognostic indicator in patients with cervical cancer treated with radiotherapy: A retrospective study.

OBJECTIVE

The cachexia index (CXI) demonstrates potential as both a diagnostic tool for cachexia and a prognostic tool for survival in cancer. However, CXI's predictive value has not been verified in cervical cancer. The purpose of this study is to investigate the prognostic value of the CXI in patients with cervical cancer treated with radiotherapy.

METHODS

We retrospectively screened patients diagnosed with cervical cancer who underwent radiotherapy in a single institution between September 2013 to September 2015. The CXI was calculated as the skeletal mass index (SMI) × albumin/neutrophil-to-lymphocyte ratio. SMI was measured by computed tomography using the muscles of the third lumbar vertebra. Survival times were evaluated using the Kaplan-Meier method and Cox proportional hazards regression. A nomogram for predicting survival was developed.

RESULTS

A total of 81 patients with cervical cancer were included. The cutoff value of the CXI was set at 59.7 using receiver operating characteristic (ROC) analyses. According to this cutoff value, 47 patients were assigned to the high-CXI group, and 34 were assigned to the low-CXI group. The Cox regression analysis showed that a low CXI was associated with decreased overall survival (hazard ratio [HR]: 3.15; 95% confidence interval [CI]: 1.24-8.00; P = 0.016). Patients in the low-CXI group also had shorter progression-free survival than those in the high-CXI group, but the difference was of borderline significance (HR: 2.26; 95% CI: 1.00-5.11; P = 0.05).

CONCLUSION

The pretreatment CXI is an independent prognostic factor in patients with FIGO II-III cervical cancer treated with radiotherapy.