Sarcopenia as a Predictor of Prognosis in Early Stage Ovarian Cancer

Abstract

Background: To identify sarcopenia as a predictive prognostic factor of ovarian cancer in terms of survival outcome in patients with early-stage ovarian cancer. Methods: Data of Konkuk University Medical Center from March 2002 to December 2017 were reviewed retrospectively. Patients who underwent surgery due to early-stage (International Federation of Gynecology and Obstetrics stage I/II) ovarian cancer and had computed tomography (CT) images taken at the initial diagnosis were included. The initial CT scan images were analyzed with SliceOmatic software (TomoVision). A sarcopenia cutoff value was defined as a skeletal muscle index of ≤ 38.7 cm 2 /m 2. Overall survival (OS) times were compared according to the existence of sarcopenia, and subgroup analyses were performed. Results: A Kaplan-Meier analysis showed a significant survival disadvantage for patients with early-stage ovarian cancer when they had sarcopenia (P < 0.001; log-rank test). Sarcopenia remained a significant prognostic factor for OS in early-stage ovarian cancer, in a Cox proportional hazards model regression analysis (HR, 21.9; 95% CI, 2.0-199.9; P = 0.006). Conclusion: This study demonstrates that sarcopenia was predictive of OS in patients with early-stage ovarian cancer. Further prospective studies with a larger number of patients are warranted to determine the extent to which sarcopenia can be used as a prognostic factor in ovarian cancer.

Progress in Applicability of Scoring Systems Based on Nutritional and Inflammatory Parameters for Ovarian Cancer

“…The third lumbar spine SMI is widely used for nutritional assessment and in the assessment of tumor prognosis. However, there is no uniform standard cut-off value (37). Staley, using SMI 41 as the cutoff value, evaluated 201 patients with epithelial ovarian cancer and found that sarcopenia was not associated with poor survival outcomes or chemotherapy toxicity.…”

Impact of Sarcopenia and Inflammation on Patients with Advanced Non-Small Cell Lung Cancer (NCSCL) Treated with Immune Checkpoint Inhibitors (ICIs): A Prospective Study

“…Sarcopenia occurs in approximately 50% of advanced cancer patients, being related to malnutrition, inflammation and tumor treatments [ 6 ]. In these patients, it has been demonstrated to be associated with worse outcomes in terms of overall survival (OS) and progression free survival (PFS), and it can be considered as a negative prognostic factor for different types of cancer, regardless of stage or treatment approach [ 7 , 8 , 9 , 10 ].…”

Association between Energy Balance-Related Factors and Clinical Outcomes in Patients with Ovarian Cancer: A Systematic Review and Meta-Analysis

“…A positive trend was also shown for OS, but it was not statistically significant ( n = 5, adjusted HR: 1.27, 95% CI: 0.98; 1.64, p = 0.070, Table 6 ). The study of Chae et al [ 66 ] appeared to be an outlier and was therefore omitted from the analysis, resulting in a reduction in the estimated HR and heterogeneity ( Table 6 , Figure 2 B).…”

“… a Study of Chae et al, 2021 was an outlier [ 66 ], b study of Kumar et al, 2016 was an outlier [ 19 ], c study of Inci et al, 2021 was an outlier [ 77 ]. Abbreviations: CI, confidence interval; HR, hazard ratio; I 2 , heterogeneity between studies; n, number of studies included in analysis; OR, odds ratio.…”

“… Association of ( A ) body mass index (Kim et al, 2014 [ 49 ], Slaughter et al, 2014 [ 93 ], Fotopoulou et al, 2011 [ 71 ], Zhang et al, 2005 [ 44 ], Aust et al, 2015 [ 59 ], Califano et al, 2013 [ 65 ], Bae et al, 2014 [ 24 ], Orskov et al, 2016 [ 21 ], Pinar et al, 2017 [ 85 ], Kim et al, 2020 [ 50 ], Previs et al, 2014 [ 86 ], Davis et al, 2016 [ 69 ], Kumar et al, 2014 [ 4 ]), ( B ) muscle mass (Chae et al, 2021 [ 66 ], Bronger et al, 2016 [ 63 ], Rutten et al, 2017 [ 89 ], Aust et al, 2015 [ 59 ], Bruno et al, 2021 [ 64 ], Kim et al, 2020 [ 50 ]) and ( C ) muscle density with overall survival Bruno et al, 2021 [ 64 ], Aust et al, 2015 [ 59 ], Ataseven et al, 2018 [ 58 ], Kumar et al, 2016 [ 19 ]. …”