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. 2021 Jan 4;36(1):e2.
doi: 10.3346/jkms.2021.36.e2.

Sarcopenia as a Predictor of Prognosis in Early Stage Ovarian Cancer

Su Hyun Chae  1   2 , Chulmin Lee  3 , Sang Hee Yoon  4 , Seung Hyuk Shim  1 , Sun Joo Lee  1 , Soo Nyung Kim  1 , Sochung Chung  5 , Ji Young Lee  6
Affiliations

Sarcopenia as a Predictor of Prognosis in Early Stage Ovarian Cancer

Su Hyun Chae et al. J Korean Med Sci. .

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.

Keywords: Early Stage Ovarian Cancer; Overall Survival; Prognostic Factor; Sarcopenia.

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Conflict of interest statement

The authors have no potential conflicts of interest to disclose.

Figures

Fig. 1
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.
Fig. 2
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).
Fig. 3
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.
See this image and copyright information in PMC

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