LB113 - PROGNOSTIC VALUE OF PRETREATMENT BODY COMPOSITION AND OVERALL SURVIVAL IN WOMEN WITH OVARIAN CANCER: INSIGHTS FROM A COX PROPORTIONAL HAZARDS ANALYSIS

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LB113

PROGNOSTIC VALUE OF PRETREATMENT BODY COMPOSITION AND OVERALL SURVIVAL IN WOMEN WITH OVARIAN CANCER: INSIGHTS FROM A COX PROPORTIONAL HAZARDS ANALYSIS

S. Benna-Doyle1,2,3,*, E. Laing2,3,4, N. Hardcastle5,6, R. McBain7,8,9, B. J. Baguley 1,2,3, N. Kiss1,2,3

1Institute for Physical Activity and Nutrition, Deakin University, Geelong , 2School of Exercise and Nutrition Sciences, Deakin University, Burwood, 3Nutrition and Speech Pathology Department, Peter MacCallum Cancer Centre, 4Sir Peter MacCallum Department of Oncology, 5Department of Oncology, Sir Peter MacCallum, University of Melbourne, 6Department of Physical Sciences, Peter MacCallum Cancer Centre, 7Gynaecological Oncology Service, Royal Women’s Hospital, 8Gynaecological Oncology Service , Mercy Hospital for Women, 9Gynaecological Oncology Service , Peter MacCallum Cancer Centre, Melbourne, Australia

 

Rationale: To investigate associations between pretreatment body composition phenotypes and overall survival in women with ovarian cancer. While low muscle mass is associated with poorer clinical outcomes in other cancer types, its prognostic value in ovarian cancer is less clear, and muscle density and overall composition may have greater clinical relevance. 

Methods: A retrospective study of 73 women diagnosed with epithelial ovarian cancer between August 2020 and March 2024, treated at Peter MacCallum Cancer Centre. Sociodemographic and treatment details were extracted from medical records. Body composition phenotypes (low skeletal muscle index [SMI], low skeletal muscle density [SMD], high total adipose tissue [TATI], sarcopenic obesity [low SMI, high TATI]) were assessed from pretreatment CT images using sex- and BMI-specific cut-off points. Survival time was defined from diagnosis to death of any cause, with records censored at data extraction. Cox proportional hazards models were fitted to assess the association between body composition phenotypes and survival. Models were adjusted for age, stage and comorbidities.

Results: Mean age was 62 (12.7), 86% (n=60) had an advanced stage (III/IV), the median comorbidity index was 2 [1-3], and 85% (n=62) were post menopausal. Across the sample, 71% (n=52) of patients were treated with neoadjuvant chemotherapy, 81% (n=59) surgery, 53% (n=39) adjuvant chemotherapy, 35% (n=26) targeted therapy, 7% (n=5) hormone therapy, and 3% (n=2) radiotherapy. The body composition analysis identified 61% (n=44) had low SMI, 58% (n=42) had low SMD, 58% (n=40) had high TATI, and 26% (n=18) had sarcopenic obesity. Women with normal SMI (n= 28, HR=.59, 95%CI: .23-1.53, p= 0.28), normal SMD (n= 30, HR= .50 95%CI: .20-1.3, p= 0.14) and those without sarcopenic obesity (n= 51, HR= .46, 95%CI: 0.095-1.14, p= 0.095) had lower hazards for mortality compared to those with altered body composition. However, wide confidence intervals and non-significant p-values indicate substantial uncertainty. 

Conclusion: Body composition is modifiable with early intervention, and normal body composition phenotypes may be protective for survival in women with ovarian cancer. Further analysis will be completed in a larger sample to confirm these associations and provide insight into high-risk phenotypes to guide clinical care. 

Disclosure of Interest: None declared