TY - JOUR
T1 - Loss of skeletal muscle during neoadjuvant chemotherapy is related to decreased survival in ovarian cancer patients
AU - Rutten, Iris J. G.
AU - van Dijk, David P. J.
AU - Kruitwagen, Roy F. P. M.
AU - Beets-Tan, Regina G. H.
AU - Damink, Steven W. M. Olde
AU - van Gorp, Toon
PY - 2016/9
Y1 - 2016/9
N2 - 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. MethodsOvarian 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. ResultsMedian OS for patients who lost SM (n=83) was 91699days, which was significantly different from median OS for patients who maintained or gained SM (n=40), which was 1431 +/- 470days (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. ConclusionsPatients 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.
AB - 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. MethodsOvarian 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. ResultsMedian OS for patients who lost SM (n=83) was 91699days, which was significantly different from median OS for patients who maintained or gained SM (n=40), which was 1431 +/- 470days (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. ConclusionsPatients 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.
KW - Sarcopenia
KW - Body composition
KW - Computed tomography
KW - Survival
KW - Ovarian neoplasms
KW - Induction chemotherapy
U2 - 10.1002/jcsm.12107
DO - 10.1002/jcsm.12107
M3 - Article
C2 - 27030813
SN - 2190-5991
VL - 7
SP - 458
EP - 466
JO - Journal of cachexia, sarcopenia and muscle
JF - Journal of cachexia, sarcopenia and muscle
IS - 4
ER -