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Multicenter Study
. 2007 Nov;107(2):260-5.
doi: 10.1016/j.ygyno.2007.06.010. Epub 2007 Aug 6.

Weight change during chemotherapy as a potential prognostic factor for stage III epithelial ovarian carcinoma: a Gynecologic Oncology Group study

L M Hess  1 , R Barakat, C Tian, R F Ozols, D S Alberts
Affiliations
Multicenter Study

Weight change during chemotherapy as a potential prognostic factor for stage III epithelial ovarian carcinoma: a Gynecologic Oncology Group study

L M Hess et al. Gynecol Oncol. 2007 Nov.

Abstract

Objective: Platinum/Paclitaxel-based chemotherapy is a current treatment for advanced epithelial ovarian cancer. We sought to explore the association between weight change during treatment and survival, as well as the association between pre-chemotherapy body mass index (BMI) and survival.

Methods: A retrospective data review was conducted of 792 advanced ovarian cancer patients who participated in a phase III randomized trial of cisplatin/paclitaxel versus carboplatin/paclitaxel. Pre-chemotherapy BMI was calculated following surgery. Weight change was defined as the ratio of body weight at completion of protocol therapy to pre-chemotherapy body weight. Progression-free survival (PFS) and overall survival (OS), classified by BMI or relative weight change, were estimated by Kaplan-Meier, and associations were assessed using a Cox model controlled for known prognostic variables (age, race, performance status, histology, tumor grade, tumor residual and treatment group).

Results: There was no association between pre-chemotherapy BMI and survival. There was a significant relationship between median OS and weight change as follows: >5% decrease=48.0 months; 0-5% decrease=49.3 months; 0-5% increase=61.1 months; and >5% increase=68.2 months. Adjusted for covariates, the relative risk of death increased by 7% for each 5% decrease in body weight (HR=0.93, 95% CI=0.88-0.99; p=0.013).

Conclusions: Change of body weight during primary chemotherapy was a strong prognostic factor for overall survival. Loss of body weight during primary therapy is an indicator for poor OS; weight gain is an indicator for improved survival. This study supports the development of strategies to minimize weight loss that can be assessed in a prospective, randomized study to improve patient outcomes.

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Figures

Figure 1
Figure 1
Kaplan-Meier estimate of overall survival (OS) by body mass index (BMI) prior to chemotherapy
Figure 2
Figure 2
Mean body weight during chemotherapy period by treatment group
Figure 3
Figure 3
Kaplan-Meier estimate of overall survival (OS) by body weight change
Figure 4
Figure 4
Risk of death (Log HR) versus weight change (%), adjusted for covariates (smoothed); negative value in weight change indicating weight loss and positive value indicating weight gain.
See this image and copyright information in PMC

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