J Korean Med Sci.  2021 Jan;36(1):e2. 10.3346/jkms.2021.36.e2.

Sarcopenia as a Predictor of Prognosis in Early Stage Ovarian Cancer

• Chae SH
• Lee C
• Yoon SH
• Shim SH
• Lee SJ
• Kim SN
• Chung S
• Lee JY

• KMID: 2510382
• DOI: http://doi.org/10.3346/jkms.2021.36.e2

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. Eighty-two 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 cm² /m² . 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 demonstrated 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.

Keyword

Early Stage Ovarian Cancer; Sarcopenia; Overall Survival; Prognostic Factor

Figure

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  Fig. 1 Flow chart of patient selection.CT = computed tomography, DCMP = dilated cardiomyopathy, CAG = coronary angiography, ESRD = end-stage renal disease, FIGO = International Federation of Gynecology and Obstetrics.

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  Fig. 2 Measurement of the degree of adiposity and muscle. (A) Computed tomography images of the third lumbar vertebra (L3) in axial view. (B) Identified area (cm2) and color-coding of skeletal muscle (red), subcutaneous adipose tissue (green), and visceral adipose tissue (yellow).

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  Fig. 3 Kaplan-Meier survival curves and log-rank tests. (A) Overall survival in patients with early-stage (FIGO stage I/II) ovarian cancer according to SMI. (B) Disease-free survival in patients with advanced ovarian cancer (FIGO stage I/II) according to SMI.FIGO = International Federation of Gynecology and Obstetrics, SMI = skeletal muscle index.

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