Prognostic role of body composition in peritoneal carcinomatosis patients undergoing cytoreduction and hyperthermic intraperitoneal chemotherapy

Background Bioelectric impedance analysis (BIA)-measured body composition and nutritional status have been used as prognostic indicators in various cancer cohorts. This study investigated whether BIA could provide information on prognosis in peritoneal carcinomatosis patients undergoing cytoreductiv...

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Published in:World journal of surgical oncology 2023-10, Vol.21 (1), p.1-345, Article 345
Main Authors: Song, Young, Bae, Myung Il, Han, Dong Woo, Park, Eun Jung, Park, Sujung, Ham, Sung Yeon
Format: Article
Language:English
Subjects:
Analysis
Bioelectrical impedance analysis
Bioelectricity
Body composition
Body fat
Body water
Cancer
Cardiac patients
Care and treatment
Chemotherapy
Colorectal cancer
Complications
Diabetes
Fat-free body mass
Gastric cancer
Health aspects
Hospitals
Hydration
Hypertension
Hyperthermic intraperitoneal chemotherapy
Kidney cancer
Medical prognosis
Medical records
Metastases
Metastasis
Morbidity
Mortality
Musculoskeletal system
Nutritional status
Oncology, Experimental
Patient outcomes
Patients
Peritoneum
Postoperative
Prognosis
Proteins
Surgery
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Summary:Background Bioelectric impedance analysis (BIA)-measured body composition and nutritional status have been used as prognostic indicators in various cancer cohorts. This study investigated whether BIA could provide information on prognosis in peritoneal carcinomatosis patients undergoing cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC). Methods We retrospectively analyzed the data of 99 patients with preoperative BIA data among those who underwent CRS and HIPEC. The association between BIA-derived parameters and intraoperative peritoneal cancer index (PCI) score was assessed. Predictive analysis for the occurrence of postoperative morbidities including major complications (Clavien-Dindo classification 3-4) and re-admission within 30 days after surgery as well as 1 year mortality was also performed. Results BIA-derived mineral (r = 0.224, p = 0.027), fat (r = - 0.202, p = 0.048), and total body water (TBW)/fat-free mass (FFM) (r = - 0.280, p = 0.005) showed significant associations with intraoperative PCI score. Lower TBW/FFM was an independent predictor of major postoperative complications (OR 0.047, 95% CI 0.003-0.749, p = 0.031) and re-admission (OR 0.094, 95% CI 0.014-0.657, p = 0.017) within 30 days after surgery. Higher fat mass was also independently associated with a higher risk of major postoperative complications (OR 1.120, 95% CI 1.006-1.248, p = 0.039) and re-admission (OR 1.123, 95% CI 1.024-1.230, p = 0.013). Intraoperative PCI score > 20 (OR 4.489, 95% CI 1.191-16.917, p = 0.027) and re-admission within 30 days after surgery (OR 5.269, 95% CI 1.288-21.547, p = 0.021) independently predicted postoperative 1-year mortality. Conclusions We demonstrate that preoperative BIA-derived TBW/FFM and fat mass were significantly correlated with metastatic extent, assessed by PCI score, in patients with peritoneal carcinomatosis. In addition, BIA-derived TBW/FFM and fat mass showed independent predictability for postoperative 30-day major complications and re-admission in patients undergoing CRS and HIPEC. Our findings suggest that assessment of BIA may improve discrete risk stratification in patients who are planned to receive CRS and HIPEC. Keywords: Bioelectrical impedance analysis, Hyperthermic intraperitoneal chemotherapy, Prognosis
ISSN:1477-7819
1477-7819
DOI:10.1186/s12957-023-03233-0