Sarcopenia as a predictor of survival and chemotoxicity in patients with epithelial ovarian cancer receiving platinum and taxane-based chemotherapy

• Published in: Gynecologic oncology 2020-03, Vol.156 (3), p.695-700
• Main Authors: Staley, S. Allison, Tucker, Katherine, Newton, Meredith, Ertel, Michelle, Oldan, Jorge, Doherty, Irene, West, Lindsay, Zhang, Yingao, Gehrig, Paola A.
• Format: Article
• Language: English
• ISSN: 0090-8258; 1095-6859
• DOI: 10.1016/j.ygyno.2020.01.003

Severe skeletal muscle loss (sarcopenia) is associated with poor cancer outcomes, including reduced survival and increased treatment toxicity. Our goal was to evaluate if sarcopenia was associated with worse survival outcomes and chemotoxicity in EOC patients undergoing primary platinum and taxane-based chemotherapy. EOC patients diagnosed between 06/2000 and 02/2017 who received treatment with platinum and taxane-based chemotherapy were included. CT abdominal images closest to the time of diagnosis were retrospectively evaluated for skeletal muscle area at the 3rd lumbar vertebrae. Measurements were obtained with use of TomoVision® radiological software (SliceOmatic – version 5.0, Quebec, Canada). Sarcopenia was defined as Skeletal Muscle Index (SMI) ≤ 41. Data analysis included Kaplan-Meier plots to assess survival, and unpaired t-tests were used to compare the means by groups. 201 EOC patients were evaluated. Sixty-four percent (128/201) met criteria for sarcopenia (SMI ≤ 41) at time of diagnosis. The mean overall survival did not differ between patients with SMI > 41 and SMI ≤ 41 (36.5 vs 40.8 months, p = 0.4, respectively). No difference in frequency of dose reduction, dose delay, hospital admissions, changes in regimen, blood transfusion, or toxicity was noted. There was no difference in distribution of toxicity grade. Sarcopenia was not associated with worse survival outcomes or chemotoxcity in EOC patients receiving first-line platinum and taxane-based chemotherapy in this cohort. Future prospective studies should focus on interventions to prevent or reverse sarcopenia and possibly increase ovarian cancer survival, performance status, and quality of life. •The majority of patients (60%) with a new diagnosis of epithelial ovarian cancer will be sarcopenic (SMI ≤ 41).•No difference in progression free or overall survival in women who are sarcopenic versus women who are not sarcopenic•Women with sarcopenia had the same frequency and grade of chemotoxicities when compared to women who are not sarcopenic.