Sarcopenia and CT Body Composition as a Prognostic Factor in Ovarian Cancer Patients Prior to Interval Debulking Surgery

• Published in: Indian journal of gynecologic oncology Vol. 22; no. 4
• Main Authors: Gadelhak, Basma N., Tawfik, Ahmed M., Batouty, Nihal M., Sobh, Donia M., Refky, Basel, Gaballah, Khaled, AbdelKhalek, Mohamed, Hamdy, Omar, Saleh, Gehad A.
• Format: Journal Article
• Language: English
• Published: New Delhi Springer India 01-12-2024
• Subjects: Medicine; Medicine & Public Health; Oncology; Original Article; Surgical Oncology; Sarcopenia; Survival; Interval debulking; Visceral obesity; Ovarian cancer
• ISSN: 2363-8397; 2363-8400
• DOI: 10.1007/s40944-024-00905-x

Introduction
To evaluate effects of sarcopenia and visceral obesity on survival and postoperative outcomes in patients with ovarian cancer undergoing interval debulking surgery.
Methods
Preoperative abdominal CT of 61 patients was analyzed using dedicated software. Skeletal muscle index (SMI), skeletal muscle attenuation (SMA), visceral adipose tissue area (VAT), and ratio of visceral/ subcutaneous adipose tissue (VAT/SAT) were calculated. Patients were subgrouped according to previously published parameters thresholds. Overall and progression-free survival (OS and PFS) were estimated using Kaplan–Meier test. Cox regression was used for analysis of hazards ratios (HR) of death.
Results
Mean OS was significantly less in sarcopenic versus non-sarcopenic groups (31.5 ± 11.3, 67 ± 5.5 months,
p
 = 0.036). Mean PFS time was 26.5 ± 9.9 for sarcopenia and 45.4 ± 4.7 months for non-sarcopenia groups,
p
 = 0.174. Mean OS time was less in low SMA compared to high SMA groups, without statistical significance (50 ± 7.7, 69 ± 6.2 months,
p
 = 0.19). Mean PFS was 37.7 ± 6.8 for low SMA and 47 ± 5.9 months for high SMA groups,
p
 = 0.297. Mean OS was longer in obese and high VAT/SAT compared to nonobese and low VAT/SAT groups without statistical significance (66.4 ± 6.2 and 61.9 ± 6 vs. 51.4 ± 8.2 and 57.4 ± 8 months,
p
 = 0.395 and 0.409, respectively). Mean PFS time was 46.2 ± 5.6 and 42.3 ± 5.5 months for obese and high VAT/SAT compared to 37.8 ± 7.4 and 42.6 ± 6.64 months for nonobese and low VAT/SAT groups,
p
 = 0.394 and
p
 = 0.865, respectively. Multivariable analyses revealed that Clavien-Dindo complications score and sarcopenia were independent predictors of poorer OS (HR:1.719,
p
 = 0.019 and HR:6.507,
p
 = 0.015, respectively).
Conclusion
Sarcopenia is predictor of poor survival in ovarian cancer patients undergoing interval debulking surgery.