J. K. Kays1, A. Desai1, R. Chauhan1, L. G. Koniaris1, T. A. Zimmers1 1Indiana University School Of Medicine,Surgery,Indianapolis, IN, USA
Introduction: Cachexia, characterized by progressive loss of body fat and muscle mass, is associated with decreased response to therapy, decreased quality of life, and decreased overall survival in malignancy. This study evaluated the associations between body composition and survival in women with ovarian serous cystadenocarcinoma (OSC).
Methods: The Cancer Imaging Archive was queried for patients with OSC. Demographic, clinical, and survival data along with abdominal computed tomography (CT) scans for 140 patients were acquired. Skeletal muscle and compartmental fat areas were measured and were divided into quartiles. Differences in survival versus tissue quartiles and clinical/demographic data were evaluated by univariate and multivariate analysis.
Results: Overall median survival was 8.0 years. Differences were significant across quartiles of mean skeletal muscle (SKM), visceral adipose tissue (VAT), subcutaneous adipose tissue (SCAT), total adipose tissue (TAT) area quartiles (p<0.001, p<0.001, p<0.001, and p<0.001 respectively). Univariate analysis revealed that the highest quartiles for VAT and SCAT were associated with significant survival advantage when compared to the lowest quartiles (p=0.04 and p=0.005, respectively). Disease stage was also associated with survival (p=0.04). Multivariate analysis showed the lowest SCAT quartile was independently associated with worse overall survival (p=0.023).
Conclusion: Low subcutaneous adipose tissue is associated with worse overall survival in women with ovarian serous cystadenocarcinoma. This might be due preferential wasting of subcutaneous fat in women with OSC, and blocking this fat wasting may improve outcomes. Further studies need to be undertaken to validate these results and comprehend mechanisms.