The association of body composition phenotypes before chemotherapy with epithelial ovarian cancer mortality.

IF 9.9 1区医学 Q1 ONCOLOGY JNCI Journal of the National Cancer Institute Pub Date : 2024-09-01 DOI:10.1093/jnci/djae112

Evan W Davis, Kristopher Attwood, Joseph Prunier, Gyorgy Paragh, Janine M Joseph, André Klein, Charles Roche, Nancy Barone, John Lewis Etter, Andrew D Ray, Britton Trabert, Matthew B Schabath, Lauren C Peres, Rikki Cannioto

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Abstract

Background: The association of body composition with epithelial ovarian carcinoma (EOC) mortality is poorly understood. To date, evidence suggests that high adiposity is associated with decreased mortality (an obesity paradox), but the impact of muscle on this association has not been investigated. Herein, we define associations of muscle and adiposity joint-exposure body composition phenotypes with EOC mortality.

Methods: Body composition from 500 women in the Body Composition and Epithelial Ovarian Cancer Survival Study was dichotomized as normal or low skeletal muscle index (SMI), a proxy for sarcopenia, and high or low adiposity. Four phenotypes were classified as fit (normal SMI and low adiposity; reference; 16.2%), overweight or obese (normal SMI and high adiposity; 51.2%), sarcopenia and overweight or obese (low SMI and high adiposity; 15.6%), and sarcopenia or cachexia (low SMI and low adiposity; 17%). We used multivariable Cox models to estimate associations of each phenotype with mortality for EOC overall and high-grade serous ovarian carcinoma (HGSOC).

Results: Overweight or obesity was associated with up to 51% and 104% increased mortality in EOC and HGSOC [Hazard Ratio (HR)] = 1.51, 95% CI = 1.05 to 2.19 and HR = 2.04, 95% CI = 1.29 to 3.21). Sarcopenia and overweight or obesity was associated with up to 66% and 67% increased mortality in EOC and HGSOC (HR = 1.66, 95% CI = 1.13 to 2.45 and HR = 1.67, 95% CI = 1.05 to 2.68). Sarcopenia or cachexia was associated with up to 73% and 109% increased mortality in EOC and HGSOC (HR = 1.73, 95% CI = 1.14 to 2.63 and HR = 2.09, 95% CI = 1.25 to 3.50).

Conclusions: Overweight or obesity, sarcopenia and overweight or obesity, and sarcopenia or cachexia phenotypes were each associated with increased mortality in EOC and HGSOC. Exercise and dietary interventions could be leveraged as ancillary treatment strategies for improving outcomes in the most fatal gynecological malignancy with no previously established modifiable prognostic factors.

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化疗前身体成分表型与上皮性卵巢癌死亡率的关系。

背景：人们对身体成分与上皮性卵巢癌（EOC）死亡率的关系知之甚少。迄今为止，有证据表明高脂肪与死亡率下降有关（肥胖悖论），但肌肉对这种关联的影响尚未得到研究。在此，我们确定了肌肉和脂肪联合暴露的身体成分表型与 EOC 死亡率的关系：身体成分与上皮性卵巢癌生存研究》中 500 名女性的身体成分被二分为正常/低骨骼肌指数（SMI）（代表肌肉疏松症）和高/低脂肪率。四种表型被分为适合/参考（正常骨骼肌指数/低脂肪率；16.2%）、超重/肥胖（正常骨骼肌指数/高脂肪率；51.2%）、肌肉疏松症/超重-肥胖（低骨骼肌指数/高脂肪率；15.6%）和肌肉疏松症/恶病质（低骨骼肌指数/低脂肪率；17%）。我们使用多变量 Cox 模型估计了每种表型与 EOC 整体死亡率和高级别浆液性卵巢癌（HGSOC）死亡率的关系：结果：超重/肥胖与 EOC 和 HGSOC 死亡率分别增加 51% 和 104% 有关（HR = 1.51，95% CI：1.05-2.19；HR = 2.04，95% CI：1.29-3.21）。肉质疏松症/超重-肥胖与 EOC 和 HGSOC 死亡率分别增加 66% 和 67% 有关（HR = 1.66，95% CI：1.13-2.45 和 HR = 1.67，95% CI：1.05-2.68）。在 EOC 和 HGSOC 中，肌肉疏松症/恶病质与死亡率分别增加 73% 和 109% 有关（HR = 1.73，95% CI：1.14-2.63 和 HR = 2.09，95% CI：1.25-3.50）：超重/肥胖、肌肉疏松症/超重-肥胖和肌肉疏松症/恶病质表型均与 EOC 和 HGSOC 死亡率增加有关。运动和饮食干预可作为辅助治疗策略，以改善这种最致命的妇科恶性肿瘤的预后。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

JNCI Journal of the National Cancer Institute 医学-肿瘤学

CiteScore

17.00

自引率

2.90%

发文量

203

审稿时长

4-8 weeks

期刊介绍： The Journal of the National Cancer Institute is a reputable publication that undergoes a peer-review process. It is available in both print (ISSN: 0027-8874) and online (ISSN: 1460-2105) formats, with 12 issues released annually. The journal's primary aim is to disseminate innovative and important discoveries in the field of cancer research, with specific emphasis on clinical, epidemiologic, behavioral, and health outcomes studies. Authors are encouraged to submit reviews, minireviews, and commentaries. The journal ensures that submitted manuscripts undergo a rigorous and expedited review to publish scientifically and medically significant findings in a timely manner.