Computed Tomography–Based Body Composition in Patients With Ovarian Cancer: Association With Chemotoxicity and Prognosis

PurposeTo assess the association between computed tomography (CT)-derived quantitative measures of body composition profiling and chemotherapy-related complications, in terms of dose reduction, premature discontinuation of chemotherapy, and cycle delays in patients with ovarian cancer. Secondary pur...

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Autores principales:	Maria Del Grande, Stefania Rizzo, Gabriele Maria Nicolino, Ilaria Colombo, Lorenzo Rossi, Lucia Manganaro, Filippo Del Grande
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	ovarian cancer body composition chemotherapy visceral adipose tissue skeletal muscle area Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
Acceso en línea:	https://doaj.org/article/f4ce1cbdfbcb46abb884fb6d10e61029
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spelling	oai:doaj.org-article:f4ce1cbdfbcb46abb884fb6d10e610292021-11-16T04:30:08ZComputed Tomography–Based Body Composition in Patients With Ovarian Cancer: Association With Chemotoxicity and Prognosis2234-943X10.3389/fonc.2021.718815https://doaj.org/article/f4ce1cbdfbcb46abb884fb6d10e610292021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fonc.2021.718815/fullhttps://doaj.org/toc/2234-943XPurposeTo assess the association between computed tomography (CT)-derived quantitative measures of body composition profiling and chemotherapy-related complications, in terms of dose reduction, premature discontinuation of chemotherapy, and cycle delays in patients with ovarian cancer. Secondary purposes were to evaluate associations between sarcopenia and survival, and to evaluate differences in body composition profiling at baseline and after neoadjuvant chemotherapy.Materials and MethodsThe study population was retrospectively selected from a database of patients with newly diagnosed ovarian cancer (any stage) referred to our Institution between Feb 2011 and Mar 2020. Clinical data were recorded, and CT images at the level of the 3rd lumbar vertebra were stored. By using specific software, skeletal muscle area (SMA), subcutaneous adipose tissue (SAT), visceral adipose tissue (VAT), and skeletal muscle density (SMD) were extracted. Skeletal muscle index (SMI) was then calculated. Statistical analysis was performed by logistic regression models to identify body composition features predictive of dose reduction, premature end of chemotherapy, and cycle delays. Kaplan-Meier analyses were performed to assess overall survival (OS) and progression-free survival (PFS). The log-rank test was used to determine differences in OS and PFS between sarcopenic and non-sarcopenic patients. Wilcoxon test was performed to compare body composition features before and after neoadjuvant chemotherapy (NACT).ResultsSixty-nine patients were included. A significant association was found between VAT and cycle delays (OR = 1.01, z = 2.01, 95% CI: 1.00–1.02, p < 0.05), between SMA and early discontinuation of chemotherapy (OR = 1.03, z = 2.10, 95% CI: 1.00–1.05, p < 0.05), and between mean SMD and cycle delays (OR = 0.92, z = −2.70, 95%CI: 0.87–0.98, p < 0.01). No significant difference emerged for OS in sarcopenic and non-sarcopenic patients, nor in CT body composition features before and after NACT.ConclusionsIn ovarian cancer patients, CT-derived body composition profiling might predict the risk of chemotoxicity. In particular, VAT and SMD are associated with chemotherapy cycle delays, and SMA with early discontinuation of chemotherapy.Maria Del GrandeStefania RizzoStefania RizzoGabriele Maria NicolinoIlaria ColomboLorenzo RossiLucia ManganaroFilippo Del GrandeFilippo Del GrandeFrontiers Media S.A.articleovarian cancerbody compositionchemotherapyvisceral adipose tissueskeletal muscle areaNeoplasms. Tumors. Oncology. Including cancer and carcinogensRC254-282ENFrontiers in Oncology, Vol 11 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	ovarian cancer body composition chemotherapy visceral adipose tissue skeletal muscle area Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
spellingShingle	ovarian cancer body composition chemotherapy visceral adipose tissue skeletal muscle area Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 Maria Del Grande Stefania Rizzo Stefania Rizzo Gabriele Maria Nicolino Ilaria Colombo Lorenzo Rossi Lucia Manganaro Filippo Del Grande Filippo Del Grande Computed Tomography–Based Body Composition in Patients With Ovarian Cancer: Association With Chemotoxicity and Prognosis
description	PurposeTo assess the association between computed tomography (CT)-derived quantitative measures of body composition profiling and chemotherapy-related complications, in terms of dose reduction, premature discontinuation of chemotherapy, and cycle delays in patients with ovarian cancer. Secondary purposes were to evaluate associations between sarcopenia and survival, and to evaluate differences in body composition profiling at baseline and after neoadjuvant chemotherapy.Materials and MethodsThe study population was retrospectively selected from a database of patients with newly diagnosed ovarian cancer (any stage) referred to our Institution between Feb 2011 and Mar 2020. Clinical data were recorded, and CT images at the level of the 3rd lumbar vertebra were stored. By using specific software, skeletal muscle area (SMA), subcutaneous adipose tissue (SAT), visceral adipose tissue (VAT), and skeletal muscle density (SMD) were extracted. Skeletal muscle index (SMI) was then calculated. Statistical analysis was performed by logistic regression models to identify body composition features predictive of dose reduction, premature end of chemotherapy, and cycle delays. Kaplan-Meier analyses were performed to assess overall survival (OS) and progression-free survival (PFS). The log-rank test was used to determine differences in OS and PFS between sarcopenic and non-sarcopenic patients. Wilcoxon test was performed to compare body composition features before and after neoadjuvant chemotherapy (NACT).ResultsSixty-nine patients were included. A significant association was found between VAT and cycle delays (OR = 1.01, z = 2.01, 95% CI: 1.00–1.02, p < 0.05), between SMA and early discontinuation of chemotherapy (OR = 1.03, z = 2.10, 95% CI: 1.00–1.05, p < 0.05), and between mean SMD and cycle delays (OR = 0.92, z = −2.70, 95%CI: 0.87–0.98, p < 0.01). No significant difference emerged for OS in sarcopenic and non-sarcopenic patients, nor in CT body composition features before and after NACT.ConclusionsIn ovarian cancer patients, CT-derived body composition profiling might predict the risk of chemotoxicity. In particular, VAT and SMD are associated with chemotherapy cycle delays, and SMA with early discontinuation of chemotherapy.
format	article
author	Maria Del Grande Stefania Rizzo Stefania Rizzo Gabriele Maria Nicolino Ilaria Colombo Lorenzo Rossi Lucia Manganaro Filippo Del Grande Filippo Del Grande
author_facet	Maria Del Grande Stefania Rizzo Stefania Rizzo Gabriele Maria Nicolino Ilaria Colombo Lorenzo Rossi Lucia Manganaro Filippo Del Grande Filippo Del Grande
author_sort	Maria Del Grande
title	Computed Tomography–Based Body Composition in Patients With Ovarian Cancer: Association With Chemotoxicity and Prognosis
title_short	Computed Tomography–Based Body Composition in Patients With Ovarian Cancer: Association With Chemotoxicity and Prognosis
title_full	Computed Tomography–Based Body Composition in Patients With Ovarian Cancer: Association With Chemotoxicity and Prognosis
title_fullStr	Computed Tomography–Based Body Composition in Patients With Ovarian Cancer: Association With Chemotoxicity and Prognosis
title_full_unstemmed	Computed Tomography–Based Body Composition in Patients With Ovarian Cancer: Association With Chemotoxicity and Prognosis
title_sort	computed tomography–based body composition in patients with ovarian cancer: association with chemotoxicity and prognosis
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/f4ce1cbdfbcb46abb884fb6d10e61029
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Computed Tomography–Based Body Composition in Patients With Ovarian Cancer: Association With Chemotoxicity and Prognosis

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