Abstract
This study aimed to investigate the impact of sarcopenia and body composition on survival outcomes in Korean patients with advanced-stage high-grade serous ovarian carcinoma (HGSOC). We retrospectively identified patients diagnosed with and treated for International Federation of Gynecology and Obstetrics stage III-IV HGSOC. Skeletal muscle index (SMI) was measured using pre-treatment computed tomography scans at the third lumbar vertebra. Sarcopenia was defined as SMI <39.0 cm2/m2. Patients’ clinicopathologic characteristics and survival outcomes were compared according to sarcopenia presence. For subgroup analysis, we also measured the total fat area from the same image. In total, 76 and 103 patients were assigned to the sarcopenia and control groups, respectively. Comorbidities, stage, serum CA-125 levels, and size of residual tumor after surgery were similar between both groups. After a median follow up of 42.7 months, both groups showed similar progression-free survival (PFS) and overall survival (OS). In subgroup analysis confined to the sarcopenia group, patients with high fat-to-muscle ratio (FMR; ≥2.1, n = 38) showed significantly worse OS than those with low FMR (<2.1, n = 38) (5-year survival rate, 44.7% vs. 80.0%; p = 0.046), whereas PFS was not different (p = 0.365). Multivariate analyses identified high FMR as an independent poor prognostic factor for OS in this group (adjusted hazard ratio, 3.377; 95% confidence interval, 1.170–9.752; p = 0.024). In conclusion, sarcopenia did not influence recurrence rates and survival in Korean patients with advanced-stage HGSOC. However, among the patients with sarcopenia, high FMR was associated with decreased OS.
Highlights
Ovarian cancer, one of the deadliest gynecologic malignancies, causes more than 150,000 deaths worldwide each year [1]
We investigated the correlations between systemic patients, correlations between and the three systemic inflammatory indices—NLR, and indices, neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio Monocyte-to-lymphocyte ratio (MLR), (MLR), Platelet-to-lymphocyte ratio (PLR)—were investigated
Rather than cancer cachexia, we focused on sarcopenia itself which may be incidentally discovered at the time of diagnosis of ovarian cancer
Summary
One of the deadliest gynecologic malignancies, causes more than 150,000 deaths worldwide each year [1]. The incidence of ovarian cancer is higher among high Human Development. Index countries, and it is gradually increasing in Korea [2]. Previous studies have suggested sarcopenia as a prognostic factor associated with poor survival and increased resistance and toxicity to chemotherapy in patients with various malignancies, including breast, small cell lung, urothelial, and gastric cancers [5,6,7,8]. In ovarian cancer, conflicting results have been reported: while some studies concluded that sarcopenia adversely affected patients’ progression-free survival (PFS) or overall survival (OS) [9,10], others could not determine a significant association of sarcopenia with survival outcomes [11,12]. There were differences in study design, population, disease setting, and definition of sarcopenia among the studies; careful attention is required to interpret the study results
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
