Evaluation of the relationship of the amount of ascites as measured quantitatively using computed tomography with chemotherapy toxicity in patients with ovarian cancer

Abstract

In this study, it was planned to investigate the effects of ascites and sarcopenia on treatment toxicity, disease free survival (DFS) and disease specific survival (DSS) times in a population of patients with stage 3–4 ovarian cancer. In this retrospective study that include 80 patients treated and followed-up for advanced stage ovarian cancer in a university hospital between 2012–2019, ascites volumes and sarcopenia indices of the patients were calculated by computed tomography from medical patient records, and their clinico-pathologic characteristics as well as laboratory variables were reviewed. The median survival was 30.10 ± 2.85 months for the patients with ascites and 54.26 ± 4.16 months without ascites (p < 0.001). The duration of DSS was found to be negatively affected in patients with ascites (Hazard Ratio (HR): 3.048), prognostic nutritional index (PNI) <47.5 (HR: 2.528), platelet (PLT) >338,000 (HR: 1.936), lactate dehydrogenase (LDH) value >320 (HR: 1.624), albumin value <4 (HR: 1.849). When factors that are found to have a significant relationship with DSS were assessed according to multivariate Cox regression analysis, the presence of ascites was identified as an independent risk factor associated with DSS (p: 0.004). The risk of developing grade 2 or 3 neutropenia, anemia and thrombocytopenia is significantly increased following the first chemotherapy course in patients with ascites when compared to those without ascites (p: 0.006). The presence of ascites in patients with ovarian cancer is a risk factor associated with chemotherapy toxicity and reduced survival.