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

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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

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Nutritional Status
Electric Impedance
Ovarian Neoplasms
Residual Neoplasm
Body Composition
Nutrition Assessment
Incidence
Malnutrition
Laparoscopy
Ovarian epithelial cancer

Keywords

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

ASJC Scopus subject areas

  • Oncology
  • Obstetrics and Gynaecology

Cite this

@article{315a21e6cd364611bf710c2cc1a760be,
title = "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",
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.",
keywords = "Complications, Debulking, Nutritional status, Ovarian cancer, Phase angle, Primary cytoreduction",
author = "Stefano Uccella and Mele, {Maria Cristina} and Lorena Quagliozzi and Emanuele Rinninella and Camilla Nero and Serena Cappuccio and Marco Cintoni and Antonio Gasbarrini and Giovanni Scambia and Anna Fagotti",
year = "2018",
month = "5",
day = "1",
doi = "10.1016/j.ygyno.2018.03.044",
language = "English",
volume = "149",
pages = "263--269",
journal = "Gynecologic Oncology",
issn = "0090-8258",
publisher = "Academic Press Inc.",
number = "2",

}

TY - JOUR

T1 - Assessment of preoperative nutritional status using BIA-derived phase angle (PhA) in patients with advanced ovarian cancer

T2 - Correlation with the extent of cytoreduction and complications

AU - Uccella, Stefano

AU - Mele, Maria Cristina

AU - Quagliozzi, Lorena

AU - Rinninella, Emanuele

AU - Nero, Camilla

AU - Cappuccio, Serena

AU - Cintoni, Marco

AU - Gasbarrini, Antonio

AU - Scambia, Giovanni

AU - Fagotti, Anna

PY - 2018/5/1

Y1 - 2018/5/1

N2 - 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.

AB - 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.

KW - Complications

KW - Debulking

KW - Nutritional status

KW - Ovarian cancer

KW - Phase angle

KW - Primary cytoreduction

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U2 - 10.1016/j.ygyno.2018.03.044

DO - 10.1016/j.ygyno.2018.03.044

M3 - Article

C2 - 29550182

AN - SCOPUS:85043536696

VL - 149

SP - 263

EP - 269

JO - Gynecologic Oncology

JF - Gynecologic Oncology

SN - 0090-8258

IS - 2

ER -