Purcell Sarah A, Elliott Sarah A, Kroenke Candyce H, Sawyer Michael B, Prado Carla M
Department of Agricultural, Food, and Nutritional Science, Faculty of Agricultural, Life, and Environmental Sciences, University of Alberta, 4-002 Li Ka Shing Centre for Health Innovation, Edmonton, AB, T6G 2E1, Canada.
Division of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA, 94612, USA.
Curr Oncol Rep. 2016 Feb;18(2):8. doi: 10.1007/s11912-015-0488-3.
Measures of body weight and anthropometrics such as body mass index (BMI) are commonly used to assess nutritional status in clinical conditions including cancer. Extensive research has evaluated associations between body weight and prognosis in ovarian cancer patients, yet little is known about the potential impact of body composition (fat mass (FM) and fat-free mass (FFM)) in these patients. Thus, the purpose of this publication was to review the literature (using PubMed and EMBASE) evaluating the impact of body weight and particularly body composition on surgical complications, morbidity, chemotherapy dosing and toxicity (as predictors of prognosis), and survival in ovarian cancer patients. Body weight is rarely associated with intra-operative complications, but obesity predicts higher rates of venous thromboembolism and wound complications post-operatively in ovarian cancer patients. Low levels of FM and FFM are superior predictors of length of hospital stay compared to measures of body weight alone, but the role of body composition on other surgical morbidities is unknown. Obesity complicates chemotherapy dosing due to altered pharmacokinetics, imprecise dosing strategies, and wide variability in FM and FFM. Measurement of body composition has the potential to reduce toxicity if the results are incorporated into chemotherapy dosing calculations. Some findings suggest that excess body weight adversely affects survival, while others find no such association. Limited studies indicate that FM is a better predictor of survival than body weight in ovarian cancer patients, but the direction of this relationship has not been determined. In conclusion, body composition as an indicator of nutritional status is a better prognostic tool than body weight or BMI alone in ovarian cancer patients.
体重测量和人体测量指标，如体重指数（BMI），常用于评估包括癌症在内的临床疾病中的营养状况。大量研究评估了卵巢癌患者体重与预后之间的关联，但对于这些患者身体组成（脂肪量（FM）和去脂体重（FFM））的潜在影响知之甚少。因此，本出版物的目的是回顾文献（使用PubMed和EMBASE），评估体重尤其是身体组成对卵巢癌患者手术并发症、发病率、化疗剂量和毒性（作为预后预测指标）以及生存的影响。体重很少与术中并发症相关，但肥胖预示着卵巢癌患者术后静脉血栓栓塞和伤口并发症的发生率更高。与单独的体重测量相比，低水平的FM和FFM是住院时间的更好预测指标，但身体组成对其他手术发病率的作用尚不清楚。肥胖会因药代动力学改变、剂量策略不精确以及FM和FFM的广泛变异性而使化疗剂量复杂化。如果将身体组成测量结果纳入化疗剂量计算中，有可能降低毒性。一些研究结果表明，超重会对生存产生不利影响，而另一些研究则未发现这种关联。有限的研究表明，在卵巢癌患者中，FM比体重是更好的生存预测指标，但这种关系的方向尚未确定。总之，在卵巢癌患者中，身体组成作为营养状况的指标，比单独的体重或BMI是更好的预后工具。
