Prognostic Value of BMI in Patients with Metastatic Cervical Cancer:A Retrospective Study From Turkey

Abstract

Background Obesity has been associated with adverse outcomes in several malignancies; however, the prognostic significance of body mass index (BMI) in metastatic cervical cancer remains unclear because of limited and conflicting evidence. This study aimed to evaluate the impact of BMI on progression-free survival (PFS) and overall survival (OS) in women with metastatic cervical cancer. Methods A retrospective analysis was conducted on 60 women diagnosed with metastatic cervical cancer between February 2014 and January 2024. Patients were stratified into high (≥25 kg/m2) and low (<25 kg/m2) BMI groups; underweight patients were included in the low-BMI group because of their small number. Survival outcomes were evaluated using Kaplan–Meier analysis and Cox proportional hazards models. Multivariate models were adjusted for age, histology, ECOG performance status, and metastatic burden. Results Among the cohort, 70% of patients had a BMI ≥25. There were no significant differences between BMI groups in baseline characteristics such as age, histological subtype, or metastatic site. However, patients with a BMI <25 demonstrated significantly better OS (2- and 5-year OS: 55.0% and44.0%) compared to those with a BMI ≥25 (22.2% and 17.8%, p = 0.024). A similar trend was observed for PFS (p = 0.037). In multivariable analysis, high BMI remained independently associated with worse OS (HR=2.55, 95% CI=1.18–5.50, p=0.017) and PFS (HR=1.87, 95% CI=1.01–3.66, p=0.045). Conclusion Higher BMI is associated with poorer overall survival in patients with metastatic cervical cancer. These findings highlight the importance of nutritional assessment and suggest that BMI may serve as a prognostic marker associated with survival outcomes in this population.