Kim, Se Ik; Yoon, Soonho; Kim, Taek Min; Cho, Jeong Yeon; Chung, Hyun Hoon; Song, Yong Sang
Gynecologic oncology
2021May ; 21 ( 1 ) :.
PMID : 33994146
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Kim, Se Ik -
Yoon, Soonho -
Kim, Taek Min -
Cho, Jeong Yeon -
Chung, Hyun Hoon -
Song, Yong Sang -
ABSTRACT
OBJECTIVE: To investigate the impact of changes in body composition during primary treatment on survival outcomes in patients with epithelial ovarian cancer (EOC).
METHODS: We retrospectively identified patients diagnosed with EOC between 2010 and 2019. Using an artificial intelligence-based tool, the volumes of skeletal muscle, visceral fat, and subcutaneous fat were measured automatically at the waist level from pre-treatment and post-treatment computed tomography scans. Associations between changes in body mass index (BMI) and volume of each body composition component and survival outcomes were evaluated.
RESULTS: A total of 208 patients were included. A significant decrease in BMI and waist volumes of skeletal muscle and visceral fat was observed during the primary treatment. Patients with BMI loss ??% showed significantly worse progression-free survival (PFS) and overall survival (OS) than those with BMI loss <5%. In multivariate analyses adjusting for clinicopathologic factors, BMI loss ??% was identified as an independent poor prognostic factor for PFS (adjusted HR, 1.565; 95% CI, 1.074-2.280; P = 0.020) and OS (adjusted HR, 2.754; 95% CI, 1.382-5.488; P = 0.004). Meanwhile, both muscle loss ??0% and visceral fat loss ??0% were associated with an increased mortality rate but did not affect disease recurrence. In multivariate analyses, muscle loss ??0% (adjusted HR, 2.069; 95% CI, 1.055-4.058; P = 0.034) and visceral fat loss ??0% (adjusted HR, 2.292; 95% CI, 1.023-5.133; P = 0.044) were poor prognostic factors for OS. Consistent results were observed in the advanced-stage disease subgroup (n = 173).
CONCLUSIONS: Changes in BMI and waist volume of skeletal muscle and visceral fat were associated with survival outcomes in patients with EOC. CI - Copyright ??2021 Elsevier Inc. All rights reserved.
keyword
Body composition; Body mass index; Epithelial ovarian cancer; Muscle mass; Ovarian neoplasms; Prognosis; Survival; Visceral fat
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