title: Impact of Body Weight and Body Composition on Ovarian Cancer Prognosis.
abstract: Measures of body weight and anthropometrics such as body mass index (BMI) are commonly used to assess nutritional status in clinical conditions including cancer. Extensive research has evaluated associations between body weight and prognosis in ovarian cancer patients, yet little is known about the potential impact of body composition (fat mass (FM) and fat-free mass (FFM)) in these patients. Thus, the purpose of this publication was to review the literature (using PubMed and EMBASE) evaluating the impact of body weight and particularly body composition on surgical complications, morbidity, chemotherapy dosing and toxicity (as predictors of prognosis), and survival in ovarian cancer patients. Body weight is rarely associated with intra-operative complications, but obesity predicts higher rates of venous thromboembolism and wound complications post-operatively in ovarian cancer patients. Low levels of FM and FFM are superior predictors of length of hospital stay compared to measures of body weight alone, but the role of body composition on other surgical morbidities is unknown. Obesity complicates chemotherapy dosing due to altered pharmacokinetics, imprecise dosing strategies, and wide variability in FM and FFM. Measurement of body composition has the potential to reduce toxicity if the results are incorporated into chemotherapy dosing calculations. Some findings suggest that excess body weight adversely affects survival, while others find no such association. Limited studies indicate that FM is a better predictor of survival than body weight in ovarian cancer patients, but the direction of this relationship has not been determined. In conclusion, body composition as an indicator of nutritional status is a better prognostic tool than body weight or BMI alone in ovarian cancer patients.
authors.affiliation: Department of Agricultural, Food, and Nutritional Science, Faculty of Agricultural, Life, and Environmental Sciences, University of Alberta, 4-002 Li Ka Shing Centre for Health Innovation, Edmonton, AB, T6G 2E1, Canada. spurcell@ualberta.ca.
authors.forename: Sarah A
authors.initials: SA
authors.lastname: Purcell
authors.affiliation: Department of Agricultural, Food, and Nutritional Science, Faculty of Agricultural, Life, and Environmental Sciences, University of Alberta, 4-002 Li Ka Shing Centre for Health Innovation, Edmonton, AB, T6G 2E1, Canada. se2@ualberta.ca.
authors.forename: Sarah A
authors.initials: SA
authors.lastname: Elliott
authors.affiliation: Division of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA, 94612, USA. candyce.h.kroenke@kp.org.
authors.forename: Candyce H
authors.initials: CH
authors.lastname: Kroenke
authors.affiliation: Department of Oncology, University of Alberta, Cross Cancer Institute, 11560 University Avenue, Edmonton, AB, T6G 1Z2, Canada. Michael.sawyer@albertahealthservices.ca.
authors.forename: Michael B
authors.initials: MB
authors.lastname: Sawyer
authors.affiliation: Department of Agricultural, Food, and Nutritional Science, Faculty of Agricultural, Life, and Environmental Sciences, University of Alberta, 4-002 Li Ka Shing Centre for Health Innovation, Edmonton, AB, T6G 2E1, Canada. cprado@ualberta.ca.
authors.forename: Carla M
authors.initials: CM
authors.lastname: Prado
mesh_terms: D000970:Antineoplastic Agents / Q000008:administration & dosage* / Q000493:pharmacokinetics; D001823:Body Composition; D015992:Body Mass Index; D001835:Body Weight; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D007431:Intraoperative Complications / Q000209:etiology* / Q000401:mortality; D009752:Nutritional Status; D009765:Obesity / Q000150:complications* / Q000401:mortality / Q000473:pathology; D010051:Ovarian Neoplasms / Q000188:drug therapy / Q000401:mortality* / Q000473:pathology; D011379:Prognosis
chemical_list: D000970:Antineoplastic Agents
keywords: Body composition; Chemotherapy toxicity; Morbidity; Nutritional status; Ovarian cancer; Survival