Low preoperative skeletal muscle density is predictive for negative postoperative outcomes in older women with ovarian cancer
Gynecologic Oncology, vol. 162, pp. 360–367
Abstract
OBJECTIVE: To determine the predictive value of lumbar skeletal muscle mass and density for postoperative outcomes in older women with advanced stage ovarian cancer. METHODS: . Low skeletal muscle density was defined as one standard deviation below the mean (muscle attenuation < 22.55 Hounsfield Units). The primary outcome was any postoperative complication ≤ 30 days after surgery. Secondary outcomes included severe complications, infections, delirium, prolonged hospital stay, discharge destination, discontinuation of adjuvant chemotherapy and mortality. RESULTS: In analysis of 213 patients, preoperative low skeletal muscle density was associated with postoperative complications ≤ 30 days after surgery (Odds Ratio (OR) 2.83; 95% Confidence Interval (CI) 1.41-5.67), severe complications (OR 3.01; 95%CI 1.09-8.33), infectious complications (OR 2.79; 95%CI 1.30-5.99) and discharge to a care facility (OR 3.04; 95%CI 1.16-7.93). Preoperative low skeletal muscle mass was only associated with infectious complications (OR 2.32; 95%CI 1.09-4.92). In a multivariable model, low skeletal muscle density was of added predictive value for postoperative complications (OR 2.57; 95%CI 1.21-5.45) to the strongest existing predictor functional impairment (KATZ-ADL ≥ 2). CONCLUSION: Low skeletal muscle density, as a proxy of muscle quality, is associated with poor postoperative outcomes in older patients with advanced stage ovarian cancer. These findings can contribute to postoperative risk assessment and clinical decision making.
Authors 16
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Vera van der Zanden corresponding
University Medical Center Groningen · University of Groningen
Affiliation as printed
University Medical Center Groningen, University of Groningen, Department of Internal Medicine, Hanzeplein 1, 9713 GZ, Groningen, the Netherlands. Electronic address: v.van.der.zanden@umcg.nl
University Medical Center Groningen, University of Groningen, Department of Internal Medicine, Hanzeplein 1, 9713 GZ, Groningen, the Netherlands
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The Netherlands Cancer Institute · Centrum voor Gynaecologische Oncologie Amsterdam
Affiliation as printed
The Netherlands Cancer Institute, Department of Gynecologic Oncology, Center for Gynecologic Oncology Amsterdam, Plesmanlaan 121, 1066 CX, Amsterdam, the Netherlands
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University Medical Center Groningen · University of Groningen
Affiliation as printed
University Medical Center Groningen, University of Groningen, Department of Radiology, Hanzeplein 1, 9713 GZ, Groningen, the Netherlands
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The Netherlands Cancer Institute · Centrum voor Gynaecologische Oncologie Amsterdam
Affiliation as printed
The Netherlands Cancer Institute, Department of Gynecologic Oncology, Center for Gynecologic Oncology Amsterdam, Plesmanlaan 121, 1066 CX, Amsterdam, the Netherlands
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The Netherlands Cancer Institute · Centrum voor Gynaecologische Oncologie Amsterdam · KU Leuven
Affiliation as printed
The Netherlands Cancer Institute, Department of Gynecologic Oncology, Center for Gynecologic Oncology Amsterdam, Plesmanlaan 121, 1066 CX, Amsterdam, the Netherlands; KU Leuven, Department of Oncology, Herestraat 49, 3000 Leuven, Belgium
KU Leuven, Department of Oncology, Herestraat 49, 3000 Leuven, Belgium
The Netherlands Cancer Institute, Department of Gynecologic Oncology, Center for Gynecologic Oncology Amsterdam, Plesmanlaan 121, 1066 CX, Amsterdam, the Netherlands
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University Medical Center Groningen · University of Groningen
Affiliation as printed
University Medical Center Groningen, University of Groningen, Department of Gynecological Oncology, Hanzeplein 1, 9713 GZ, Groningen, the Netherlands
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Leiden University Medical Center
Affiliation as printed
Leiden University Medical Center, Leiden University, Department of Medical Oncology, Albinusdreef 2, 2333 ZA, Leiden, the Netherlands
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Leiden University Medical Center
Affiliation as printed
Leiden University Medical Center, Leiden University, Department of Medical Oncology, Albinusdreef 2, 2333 ZA, Leiden, the Netherlands
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Leiden University · Leiden University Medical Center
Affiliation as printed
Leiden University Medical Center, Leiden University, Department of Obstetrics and Gynecology, Albinusdreef 2, 2333 ZA, Leiden, the Netherlands
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Medisch Centrum Haaglanden · Stichting Haaglanden Medisch Centrum
Affiliation as printed
Haaglanden Medical Center, Department of Obstetrics and Gynecology, Lijnbaan 32, 2512 VA, The Hague, the Netherlands
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Medisch Centrum Haaglanden · Stichting Haaglanden Medisch Centrum
Affiliation as printed
Haaglanden Medical Center, Department of Radiology, Lijnbaan 32, 2512 VA, The Hague, the Netherlands
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Affiliation as printed
Reinier de Graaf Group, Department of Obstetrics and Gynecology, Reinier de Graafweg 5, 2625 AD, Delft, the Netherlands
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Affiliation as printed
Haga Medical Center, Department of Obstetrics and Gynecology, Els Borst-Eilersplein 275, 2545 AA, The Hague, the Netherlands
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Affiliation as printed
Haga Medical Center, Department of Medical Oncology, Els Borst-Eilersplein 275, 2545 AA, The Hague, the Netherlands
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Barbara C. Van Munster corresponding
University Medical Center Groningen · University of Groningen
Affiliation as printed
University Medical Center Groningen, University of Groningen, Department of Internal Medicine, Hanzeplein 1, 9713 GZ, Groningen, the Netherlands. Electronic address: b.c.van.munster@umcg.nl
University Medical Center Groningen, University of Groningen, Department of Internal Medicine, Hanzeplein 1, 9713 GZ, Groningen, the Netherlands
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Leiden University Medical Center
Affiliation as printed
Leiden University Medical Center, Leiden University, Department of Medical Oncology, Albinusdreef 2, 2333 ZA, Leiden, the Netherlands
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