Sarcopenia in patients with endometrial cancer treated with chemotherapy is correlated with febrile neutropenia

Sarcopenia, characterized by reduced skeletal muscle mass, may impact chemotherapy tolerance and outcomes in cancer patients. In this study we aimed to investigate the correlation of sarcopenia with chemotherapy-related complications and oncological outcomes in patients with endometrial cancer. We retrospectively collected data from the electronic medical records of patients who underwent chemotherapy from January 2015 to August 2021. We measured the L3 vertebral skeletal muscle index (L3SMI), using the abdominopelvic computerized tomography and sarcopenia was defined as an L3SMI of <41 cm 2 /m 2 . We collected clinicopathological data and demographic information. We also assessed chemotherapy-related hematologic complications and oncologic outcomes between the groups. A total of 117 patients underwent chemotherapy at our hospital, and 97 patients were included in our study (n = 28 and 69 patients in the sarcopenia and non-sarcopenia groups, respectively). The body mass index of patients in the sarcopenia group was lower than that of patients in the non-sarcopenia group (22.55 ± 2.38 vs. 26.85 ± 4.52 kg/m 2 , P < 0.0001). The prevalence of febrile neutropenia in the sarcopenia group was higher than that in the non-sarcopenia group (42.9 % vs. 18.8 %, P = 0.0148). However, oncological outcomes, such as recurrence rate and prevalence of anemia after the first chemotherapy, were not associated with sarcopenia. Patients with endometrial cancer and sarcopenia who underwent chemotherapy showed increased chemotherapy-related complications, such as febrile neutropenia. These findings suggest the need for close monitoring of sarcopenic patients and consideration of prophylactic measures, such as granulocyte-colony stimulating factor administration.