The role of sarcopenia in the development of early complications in patients with Advanced Epithelial Ovarian Carcinoma undergoing Cytoreductive Surgery

Abstract

Purpose Sarcopenia has been identified as a prognostic factor in various cancers. The aim of the study is to investigate the role of sarcopenia in the development of early complications following Primary Cytoreductive Surgery in advanced stage ovarian cancer patients. Methods A total of 57 patients who underwent Cytoreductive Surgery due to advanced stage ovarian cancer at the Surgical Oncology Clinic of ………….. University Hospital between January 2013 and June 2021 were retrospectively analyzed. Routine preoperative Computed Tomography(CT) images were used to measure the cross-sectional areas of the paraspinal muscles, abdominal wall muscles at the L3 level in cm2. The Skeletal Muscle Index (SMI) and Psoas Muscle Index (PMI) values were calculated. Postoperative early complications were classified as Clavien-Dindo grade 3 and above major complications. Results Based on SMI measurements, 23 patients with SMI < 38.5 were classified as sarcopenic, while 34 patients with SMI ≥ 38.5 were classified as nonsarcopenic; based on PMI measurements, 19 patients with PMI < 4.3 were classified as sarcopenic, while 38 patients with PMI ≥ 4.3 were classified as nonsarcopenic. Major complications occurring in the early postoperative period were significantly more common in the sarcopenic group. High Peritoneal Carcinomatosis Index (PCI) score and FIGO 3C stage were associated with a significantly higher incidence of early complications. High PCI score and SMI < 38.5 value were identified as risk factors for postoperative early complications. Conclusions The quantitative measurements of sarcopenia using routine CT imaging for preoperative staging are a useful and cost-effective method. Determining the sarcopenic status of patients before treatment offers an advantage in predicting treatment complications.