Background: Previous studies have reported that loss of muscle mass and quality (sarcopenia) is related to disability, poor quality of life, and decreased survival across various cancer types. This retrospective study aimed to evaluate the influence of preoperative skeletal muscle quantification on prognosis in epithelial ovarian cancer (EOC) patients undergoing primary debulking surgery (PDS). Methods: The medical records of 222 EOC patients treated from June 2002 and December 2017 were reviewed. Preoperative computed tomography (CT) scans at the level of the third lumbar vertebra were used to identify and classify skeletal muscle based on radiodensity. The proportion of low-attenuation muscle within the total skeletal muscle area was calculated. Healthy muscle was defined as containing 23.5% or less low attenuation muscle, determined using a maximal chi-square test. Results: Based on these criteria, 84 patients were classified into the healthy muscle group, while the remaining 138 patients were categorized into the unhealthy muscle group. Patients with healthy muscle demonstrated improved overall survival (OS) and progression-free survival compared with those in the unhealthy muscle group. Multivariate analysis identified unhealthy muscle as a significant predictor of decreased survival, alongside with advanced stage, high-grade histology, and suboptimal surgery. Conclusions: Preoperative skeletal muscle quantification was identified as an independent prognostic factor in EOC patients. EOC patients with healthy muscle demonstrated a better prognosis than patients with unhealthy muscle.
Oh et al. (Fri,) studied this question.