abstract
BACKGROUND:
Malnutrition,
weight loss, and muscle wasting (sarcopenia) are common among women
with advanced ovarian cancer and have been associated with adverse
clinical outcomes and survival. Our objective is to investigate overall
survival (OS) related to changes in skeletal muscle (SM) for patients
with advanced ovarian cancer treated with neoadjuvant chemotherapy and
interval debulking.
METHODS:
Ovarian cancer patients (
n
= 123) treated with neoadjuvant chemotherapy and interval debulking in
the area of Maastricht (the Netherlands) between 2000 and 2014 were
included retrospectively. Surface areas of SM and adipose tissue were
defined on computed tomography at the level of the third lumbar
vertebra. Low SM at baseline and SM changes during chemotherapy were
compared with Kaplan Meier curves, and Cox-regression models were
applied to test predictors of OS.
RESULTS:
Median OS for patients who lost SM (
n = 83) was 916 ± 99 days, which was significantly different from median OS for patients who maintained or gained SM (
n = 40), which was 1431 ± 470 days (
P
= 0.004). Loss of SM was also a significant predictor of OS in
multivariable Cox-regression analysis (hazard ratio 1.773 (95%CI:
1.018-3.088),
P = 0.043). Low baseline SM did not influence survival.
CONCLUSIONS:
Patients
with ovarian cancer have a worse survival when they lose SM during
neoadjuvant chemotherapy. Evaluation of low SM at a specific time point
is not prognostic for OS. External and prospective validation of these
findings is imperative. Nutritional, pharmacological, and/or physical
intervention studies are necessary to establish whether SM impairment
can be prevented to prolong ovarian cancer survival.
0 comments :
Post a Comment
Your comments?
Note: Only a member of this blog may post a comment.