J Gynecol Oncol.  2017 Nov;28(6):e80. 10.3802/jgo.2017.28.e80.

Nutritional status, cachexia, and anorexia in women with peritoneal metastasis and intraperitoneal chemotherapy: a longitudinal analysis

• Hilal Z
• Rezniczek
• Klenke R
• Dogan A
• Tempfer CB

• KMID: 2413206
• DOI: http://doi.org/10.3802/jgo.2017.28.e80

Abstract

OBJECTIVE
To describe the nutritional status of women with peritoneal metastasis (PM) from recurrent ovarian, fallopian, or peritoneal cancer and to assess longitudinal variations of the cachexia-anorexia syndrome (CAS) during palliative pressurized intraperitoneal aerosol chemotherapy (PIPAC).
METHODS
Nutritional assessment included body mass index (BMI), bioelectrical impedance analysis (BIA), and blood chemistry. CAS presence/absence was recorded before and during repeated cycles (1-11) of PIPAC.
RESULTS
Eighty-four patients with peritoneal cancer (n=5) or PM from recurrent ovarian (n=77) or fallopian tube (n=2) cancer were included. At baseline, resting metabolism (RM) (1,432±172 kcal/day), visceral fat level (7.5±3.2), skeletal muscle mass (27.2%±4.6%), upper arm circumference (27.9±4.6 cm), lower leg circumference (35.1±3.9 cm), serum parameters (albumin [3.5±0.7 g/dL], total protein [6.3±0.9 g/dL], and transferrin [202±60 mg/dL]) were below normal limits. C-reactive protein (CRP) (4.3±6.8 mg/dL), caliper body fat (35.7%±6.3%), and total body fat mass (35.6%±8.5%) were above normal limits. Nineteen/84 (23%) patients had CAS at baseline. Deterioration or stabilization/improvement of CAS was observed in 9/55 (16.4%) and 46/55 (83.6%) patients with follow-up data, respectively. Baseline body fat mass, visceral fat level, skeletal muscle mass, caliper body fat, BMI, ascites, Karnofsky index, RM, and CRP, as well as tumor response were not predictive of CAS deterioration.
CONCLUSION
Nutritional decline and onset or deterioration of CAS are difficult to predict. Careful measuring and monitoring of nutritional parameters and CAS in all patients seems to be necessary in order to identify those patients in need of enteral/parenteral nutrition support.

Keyword

Intraperitoneal; Ovarian Neoplasms; Nutrition; Aerosol; Palliative

MeSH Terms

Adipose Tissue
Aerosols
Aged
Anorexia/*epidemiology/metabolism
Antineoplastic Combined Chemotherapy Protocols/therapeutic use
Ascites/epidemiology
Body Mass Index
C-Reactive Protein/metabolism
Cachexia/*epidemiology/metabolism
Carcinoma/drug therapy/*epidemiology/metabolism/secondary
Cisplatin/administration & dosage
Doxorubicin/administration & dosage
Energy Metabolism
Fallopian Tube Neoplasms/*pathology
Female
Humans
Injections, Intraperitoneal
Intra-Abdominal Fat
Longitudinal Studies
Middle Aged
Muscle, Skeletal
*Nutritional Status
Ovarian Neoplasms/*pathology
Peritoneal Neoplasms/drug therapy/*epidemiology/metabolism/secondary
Proteins/metabolism
Serum Albumin/metabolism
Skinfold Thickness
Syndrome
Aerosols
Proteins
Serum Albumin
Doxorubicin
C-Reactive Protein
Cisplatin