Malnutrition tied to poor survival in metastatic cervical cancer

Low serum albumin levels appear to be an important risk factor for poor survival outcomes among patients with metastatic cervical cancer, a recent study has found.

Forty-three patients participated in the present retrospective analysis, all of whom had stage IVB disease. Albumin levels were used as the index of malnutrition, while study outcomes included overall survival (OS) and progression-free survival (PFS).

Over a median follow-up of 16.4 months, Kaplan-Meier analysis revealed 1- and 2-year OS rates of 61.6 percent and 48.6 percent, respectively. Corresponding PFS rates were 25.0 percent and 16.7 percent.

Moreover, receiver operating characteristic curve analysis revealed that albumin was a strong laboratory-based predictor of 1-year survival in this patient population, with a maximum area under the curve of 0.729 at an optimal cut-off value of 3.3 g/dL. The sensitivity and specificity estimates were 60 percent and 78.6 percent, respectively.

Multivariate Cox proportional hazard analysis showed that patients whose serum albumin fell below the cut-off were more than thrice as likely to die of any causes than comparators with adequate albumin concentrations (hazard ratio [HR], 3.40, 95 percent confidence interval [CI], 1.38–8.21; p=0.008). Treatment with concurrent chemoradiotherapy (CCRT) was also an important predictor of OS (HR, 3.46, 95 percent CI, 1.24–8.87; p=0.02).

In contrast, PFS showed no such interaction with serum albumin.

“Our observation that albumin not only predicts the prognosis of patients with organ-metastatic cervical cancer but also indicates the possibility of more effective treatment for some patients with a promising long-term prognosis is of value,” the researchers said.

“In other words, even in patients with organ-metastatic cervical cancer, if the albumin level is >3.3 g/dL, CCRT may be more effective in prolonging life as the initial treatment,” they added.

Future studies are needed to validate these findings.