title: Investigating the Impact of Body Mass Index on Intraperitoneal Chemotherapy Outcomes in Ovarian and Fallopian Tube Cancer.
abstract: The aim of this study was to investigate the impact of body mass index (BMI) on completion, complications, and clinical outcomes of intraperitoneal (IP) chemotherapy in patients with advanced-stage ovarian cancer.
  
  
  
  Patients with optimally cytoreduced International Federation of Gynecology and Obstetrics stage IIIC ovarian cancer treated with IP chemotherapy were retrospectively identified using an institutional review board-approved database. Clinical data were abstracted from the longitudinal medical record. Survival estimates were calculated using the Kaplan-Meier method.
  
  
  
  Ninety-two patients (35.5%) completed at least one cycle of IP chemotherapy. For these patients, there was no difference in histology, surgical complexity, or degree of cytoreduction based on BMI. Sixty-five percent of normal weight, 70% of overweight, and 59.1% of obese women completed 6 cycles (P = 0.697). There was also no significant difference in IP chemotherapy complications (P = 0.303). Body mass index had no impact on disease-free survival (P = 0.44) or overall survival, with a median overall survival of 68.5 months for normal weight, 65.9 months for overweight, and 61.7 months for obese women (P = 0.25). However, on multivariate analysis, obesity had an odds ratio of 2.92 (P = 0.02) for mortality. There was a trend toward treatment with intravenous chemotherapy (84.2%) over IP (15.8%) in patients with class II obesity (P = 0.06).
  
  
  
  There was no difference in completion of IP chemotherapy or complications with respect to BMI; however, there was a trend away from treatment with IP therapy in extreme obesity. These data suggest that IP chemotherapy is feasible in obese patients without incurring increased morbidity.
authors.affiliation: *Division of Gynecologic Oncology, Brigham and Women's Hospital, Harvard Medical School, †Division of Gynecologic Oncology, Vincent Obstetrics and Gynecology, Massachusetts General Hospital, Harvard Medical School, Boston, MA; and ‡Saint Peter's University Hospital, New Brunswick, NJ.
authors.forename: Michelle
authors.initials: M
authors.lastname: Davis
authors.forename: Emeline
authors.initials: E
authors.lastname: Aviki
authors.forename: J Alejandro
authors.initials: JA
authors.lastname: Rauh-Hain
authors.forename: Michael
authors.initials: M
authors.lastname: Worley
authors.forename: Ross
authors.initials: R
authors.lastname: Berkowitz
authors.forename: John
authors.initials: J
authors.lastname: Schorge
authors.forename: Michael
authors.initials: M
authors.lastname: Muto
authors.forename: Rachel
authors.initials: R
authors.lastname: Clark Sisodia
authors.forename: Neil
authors.initials: N
authors.lastname: Horowitz
authors.forename: Marcela
authors.initials: M
authors.lastname: Del Carmen
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D000068258:Bevacizumab / Q000008:administration & dosage; D015992:Body Mass Index; D016190:Carboplatin / Q000008:administration & dosage; D002945:Cisplatin / Q000008:administration & dosage; D018572:Disease-Free Survival; D005185:Fallopian Tube Neoplasms / Q000188:drug therapy* / Q000473:pathology; D005260:Female; D006801:Humans; D007263:Infusions, Parenteral; D008875:Middle Aged; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000188:drug therapy* / Q000473:pathology; D017239:Paclitaxel / Q000008:administration & dosage; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D000068258:Bevacizumab; D016190:Carboplatin; D017239:Paclitaxel; D002945:Cisplatin