Conrad Lesley B, Awdeh Haitham, Acosta-Torres Stefany, Conrad Steven A, Bailey April A, Miller David S, Lea Jayanthi S
The University of Texas Southwestern Medical Center, Dallas, Texas.
University of Texas Medical School, Houston, Texas.
J Surg Oncol. 2018 Apr;117(5):1020-1028. doi: 10.1002/jso.24990. Epub 2018 Feb 6.
Age and frailty have been correlated with poor clinical outcomes in cancer. Core muscle index (CMI) and nutritional status are integral in assessing frailty. We explored the effect of pre-operative serum albumin and body composition on clinical outcomes in patients with epithelial ovarian cancer (EOC).
We identified stage III-IV EOC patients undergoing primary cytoreductive surgery from 2007 to 2015. Data were abstracted from medical records. Body composition measurements were obtained from pre-operative imaging. Psoas muscle cross-sectional area was normalized to height to determine CMI. Sarcopenia was defined as CMI below the population mean. The influence of sarcopenia on short-term morbidity was evaluated. Relationships among body composition measurements and albumin were assessed with Spearman correlations. Patient characteristics and body composition measurements between patients with and without sarcopenia were compared with parametric and non-parametric statistical methods. Kaplan-Meier survival curves were compared using log-rank.
102 women met inclusion criteria. Sarcopenia correlated with albumin (P = 0.0002). Sarcopenia was not associated with short-term morbidity or time to recurrence. Sarcopenia was associated with nearly a fourfold increased risk of death when hypoalbuminemia was present (P = 0.02).
Pre-operative sarcopenia in combination with hypoalbuminemia was associated with significantly worse survival.
年龄和身体虚弱与癌症患者不良的临床预后相关。核心肌肉指数（CMI）和营养状况是评估身体虚弱的重要组成部分。我们探讨了术前血清白蛋白和身体成分对上皮性卵巢癌（EOC）患者临床预后的影响。
我们确定了2007年至2015年接受初次肿瘤细胞减灭术的III-IV期EOC患者。数据从病历中提取。身体成分测量值来自术前影像学检查。腰大肌横截面积除以身高以确定CMI。肌肉减少症定义为CMI低于人群均值。评估肌肉减少症对短期发病率的影响。用Spearman相关性评估身体成分测量值与白蛋白之间的关系。采用参数和非参数统计方法比较有和无肌肉减少症患者的患者特征和身体成分测量值。使用对数秩检验比较Kaplan-Meier生存曲线。
102名女性符合纳入标准。肌肉减少症与白蛋白相关（P = 0.0002）。肌肉减少症与短期发病率或复发时间无关。当存在低白蛋白血症时，肌肉减少症与死亡风险增加近四倍相关（P = 0.02）。
术前肌肉减少症与低白蛋白血症共同存在与显著更差的生存率相关。
