Department of Gynaecology, Amsterdam UMC, the Netherlands.
Department of Gynaecology, Amsterdam UMC, the Netherlands.
Gynecol Oncol. 2021 Jan;160(1):187-192. doi: 10.1016/j.ygyno.2020.10.015. Epub 2020 Oct 21.
Visceral obesity (VO) is a risk factor for developing postoperative complications in patients undergoing abdominal oncological surgery. However, in ovarian cancer patients this influence of body composition on postoperative morbidity is not well established. The aim of this study is to assess the association between body composition and complications in patients with advanced ovarian cancer undergoing cytoreductive surgery.
Patients with FIGO stage 3 or 4 ovarian cancer between 2006 and 2017 were included. Visceral fat area, total skeletal mass and total fat area were measured on a single slice on the level of L3-L4 of the preoperative CT-scan. VO was defined as visceral fat ≥100cm. The perioperative data were extracted retrospectively. A multivariate logistic regression analysis was performed to test the predictive value of multiple variables such as body composition, albumin levels and preoperative morbidity.
298 consecutive patients out of nine referring hospitals were included. VO patients were more likely to be hypertensive (38% vs 17% p < 0.001), and to have an ASA 3 score (21% vs 10% P = 0.012). Complications occurred more often in VO patients (43% vs 21% P < 0.001). Thrombotic events were found in 4.9% of VO patients versus 0.6% of the non-visceral obese patients (p = 0.019). VO(OR: 4.37, p < 0.001), hypertension (OR:1.9, p = 0.046) and duration of surgery (OR: 1.004, p = 0.017) were predictors of post-surgical complications. Muscle mass is not a predictor of complications.
Visceral obesity is associated with a higher occurrence of complications in patients with advanced ovarian cancer undergoing cytoreductive surgery.
内脏肥胖（VO）是接受腹部肿瘤手术的患者术后发生并发症的危险因素。然而，在卵巢癌患者中，身体成分对术后发病率的影响尚不清楚。本研究旨在评估在接受细胞减灭术的晚期卵巢癌患者中，身体成分与并发症之间的关系。
纳入 2006 年至 2017 年间FIGO 分期为 3 或 4 期的卵巢癌患者。在术前 CT 扫描的 L3-L4 水平上测量单个切片上的内脏脂肪面积、总骨骼质量和总脂肪面积。VO 定义为内脏脂肪≥100cm。回顾性提取围手术期数据。进行多变量逻辑回归分析，以测试身体成分、白蛋白水平和术前发病率等多个变量的预测值。
9 家转诊医院共纳入 298 例连续患者。VO 患者更可能患有高血压（38%比 17%，p<0.001），ASA 3 评分更高（21%比 10%，P=0.012）。VO 患者的并发症发生率更高（43%比 21%，P<0.001）。血栓事件在 VO 患者中占 4.9%，而非内脏肥胖患者中占 0.6%（p=0.019）。VO（OR：4.37，p<0.001）、高血压（OR：1.9，p=0.046）和手术时间（OR：1.004，p=0.017）是术后并发症的预测因素。肌肉量不是并发症的预测因素。
内脏肥胖与接受细胞减灭术的晚期卵巢癌患者并发症发生率较高相关。
