Assessment of preoperative nutritional status using BIA-derived phase angle (PhA) in patients with advanced ovarian cancer: Correlation with the extent of cytoreduction and complications

Stefano Uccella, Maria Cristina Mele, Lorena Quagliozzi, Emanuele Rinninella, Camilla Nero, Serena Cappuccio, Marco Cintoni, Antonio Gasbarrini, Giovanni Scambia, Anna Fagotti

Research output: Contribution to journalArticle

Abstract

Objective: To investigate whether patients' altered body composition (measured with bioimpedentiometry), due to a poor nutritional status, predicts the incidence of no residual disease at primary debulking and the risk of complications in patients with newly-diagnosed advanced epithelial ovarian cancer (EOC). Methods: Data regarding patients with newly-diagnosed stage IIIC-IV EOC undergoing elective nutritional assessment between December 2016 and March 2017, were prospectively collected. Bioelectrical impedance analysis (BIA) with measurement of BIA-derived phase angle [PhA] at 50 KHz, was accomplished. Only patients with disease which was considered resectable at staging laparoscopy were submitted to open primary cytoreduction. The rate of residual tumor (RT) = 0 and the incidence of complications were assessed. Results: Seventy patients were included. Fifty-two of them were submitted to primary cytoreduction (74.3%) and 48 (68.6% of the entire cohort, 92.3% of those who underwent primary debulking) had RT = 0 at the end of surgery. Median values of PhA were significantly lower in patients with RT > vs. =0 (4.7, range: 3.6–5.8 vs. 5.3, range: 4.2–6.8; p = 0.001). Twenty-four (out of the 52 operated) patients (46.2%) developed at least one complication. PhA was significantly lower in patients with vs. without complications (5, range: 3.6–6.4, vs. 5.4, range 4.5–6.8; p = 0.03). After multivariable analysis, Fagotti score and PhA were the only independent predictors of residual disease (OR:13.56; 95%CI:1.33–137.6; p = 0.027 and 9.24; 1.16–73.43; p = 0.036, respectively) and of any complication (OR:4.9;95%CI:1.17–20.6; p = 0.03 and 7.27; 1.45–36.4; p = 0.01, respectively). Conclusions: Derangement of body composition (likely due to disease-related malnutrition) expressed as a low phase angle, is an independent predictor of residual disease and peri-operative complications at the time of upfront cytoreduction for advanced EOC.

Original languageEnglish
Pages (from-to)263-269
Number of pages7
JournalGynecologic Oncology
Volume149
Issue number2
DOIs
Publication statusPublished - May 1 2018

Keywords

  • Complications
  • Debulking
  • Nutritional status
  • Ovarian cancer
  • Phase angle
  • Primary cytoreduction

ASJC Scopus subject areas

  • Oncology
  • Obstetrics and Gynaecology

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