title: Skeletal Muscle Depletion and Markers for Cancer Cachexia Are Strong Prognostic Factors in Epithelial Ovarian Cancer.
abstract: OBJECTIVE
  Tumor cachexia is an important prognostic parameter in epithelial ovarian cancer (EOC). Tumor cachexia is characterized by metabolic and inflammatory disturbances. These conditions might be reflected by body composition measurements (BCMs) ascertained by pre-operative computed tomography (CT). Thus, we aimed to identify the prognostically most relevant BCMs assessed by pre-operative CT in EOC patients.
  
  
  METHODS
  We evaluated muscle BCMs and well established markers of nutritional and inflammatory status, as well as clinical-pathological parameters in 140 consecutive patients with EOC. Furthermore, a multiplexed inflammatory marker panel of 25 cytokines was used to determine the relationship of BCMs with inflammatory markers and patient's outcome. All relevant parameters were evaluated in uni- and multivariate survival analysis.
  
  
  RESULTS
  Muscle attenuation (MA)-a well established BCM parameter-is an independent prognostic factor for survival in multivariate analysis (HR 2.25; p = 0.028). Low MA-reflecting a state of cachexia-is also associated with residual tumor after cytoreductive surgery (p = 0.046) and with an unfavorable performance status (p = 0.015). Moreover, MA is associated with Eotaxin and IL-10 out of the 25 cytokine multiplex marker panel in multivariate linear regression analysis (p = 0.021 and p = 0.047, respectively).
  
  
  CONCLUSIONS
  MA-ascertained by routine pre-operative CT-is an independent prognostic parameter in EOC patients. Low MA is associated with the inflammatory, as well as the nutritional component of cachexia. Therefore, the clinical value of pre-operative CT could be enhanced by the assessment of MA.
authors.affiliation: Department of Gynaecology and Gynaecological Oncology, Gynecologic Cancer Unit, Comprehensive Cancer Center, Medical University of Vienna, Vienna, 1090, Austria.
authors.forename: Stefanie
authors.initials: S
authors.lastname: Aust
authors.affiliation: Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria, 1090, Austria.
authors.forename: Thomas
authors.initials: T
authors.lastname: Knogler
authors.affiliation: Department of Gynaecology and Gynaecological Oncology, Gynecologic Cancer Unit, Comprehensive Cancer Center, Medical University of Vienna, Vienna, 1090, Austria.
authors.forename: Dietmar
authors.initials: D
authors.lastname: Pils
authors.affiliation: Department of Gynaecology and Gynaecological Oncology, Gynecologic Cancer Unit, Comprehensive Cancer Center, Medical University of Vienna, Vienna, 1090, Austria.
authors.forename: Eva
authors.initials: E
authors.lastname: Obermayr
authors.affiliation: Department of Gynaecology and Gynaecological Oncology, Gynecologic Cancer Unit, Comprehensive Cancer Center, Medical University of Vienna, Vienna, 1090, Austria.
authors.forename: Alexander
authors.initials: A
authors.lastname: Reinthaller
authors.affiliation: Department of Gynaecology and Gynaecological Oncology, Gynecologic Cancer Unit, Comprehensive Cancer Center, Medical University of Vienna, Vienna, 1090, Austria.
authors.forename: Lisa
authors.initials: L
authors.lastname: Zahn
authors.affiliation: Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria, 1090, Austria.
authors.forename: Ilja
authors.initials: I
authors.lastname: Radlgruber
authors.affiliation: Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria, 1090, Austria.
authors.forename: Marius Erik
authors.initials: ME
authors.lastname: Mayerhoefer
authors.affiliation: Department of Gynaecology and Gynaecological Oncology, Gynecologic Cancer Unit, Comprehensive Cancer Center, Medical University of Vienna, Vienna, 1090, Austria.
authors.forename: Christoph
authors.initials: C
authors.lastname: Grimm
authors.affiliation: Department of Gynaecology and Gynaecological Oncology, Gynecologic Cancer Unit, Comprehensive Cancer Center, Medical University of Vienna, Vienna, 1090, Austria.
authors.forename: Stephan
authors.initials: S
authors.lastname: Polterauer
mesh_terms: D000368:Aged; D014408:Biomarkers, Tumor / Q000097:blood*; D001823:Body Composition; D002100:Cachexia / Q000097:blood* / Q000000981:diagnostic imaging / Q000209:etiology; D000077216:Carcinoma, Ovarian Epithelial; D016207:Cytokines / Q000097:blood; D005260:Female; D006801:Humans; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000000981:diagnostic imaging*; D009375:Neoplasms, Glandular and Epithelial / Q000097:blood / Q000150:complications / Q000000981:diagnostic imaging*; D010051:Ovarian Neoplasms / Q000097:blood / Q000150:complications / Q000000981:diagnostic imaging*; D011379:Prognosis; D011859:Radiography
chemical_list: D014408:Biomarkers, Tumor; D016207:Cytokines