TY - JOUR
T1 - Weight change during chemotherapy as a potential prognostic factor for stage III epithelial ovarian carcinoma
T2 - A Gynecologic Oncology Group study
AU - Hess, L. M.
AU - Barakat, R.
AU - Tian, C.
AU - Ozols, R. F.
AU - Alberts, D. S.
PY - 2007/11/1
Y1 - 2007/11/1
N2 - Objective: Platinum/Paclitaxel-based chemotherapy is a current treatment for advanced epithelial ovarian cancer. We sought to explore the association between weight change during treatment and survival, as well as the association between pre-chemotherapy body mass index (BMI) and survival. Methods: A retrospective data review was conducted of 792 advanced ovarian cancer patients who participated in a phase III randomized trial of cisplatin/paclitaxel versus carboplatin/paclitaxel. Pre-chemotherapy BMI was calculated following surgery. Weight change was defined as the ratio of body weight at completion of protocol therapy to pre-chemotherapy body weight. Progression-free survival (PFS) and overall survival (OS), classified by BMI or relative weight change, were estimated by Kaplan-Meier, and associations were assessed using a Cox model controlled for known prognostic variables (age, race, performance status, histology, tumor grade, tumor residual and treatment group). Results: There was no association between pre-chemotherapy BMI and survival. There was a significant relationship between median OS and weight change as follows: > 5% decrease = 48.0 months; 0-5% decrease = 49.3 months; 0-5% increase = 61.1 months; and > 5% increase = 68.2 months. Adjusted for covariates, the relative risk of death increased by 7% for each 5% decrease in body weight (HR = 0.93, 95% CI = 0.88-0.99; p = 0.013). Conclusions: Change of body weight during primary chemotherapy was a strong prognostic factor for overall survival. Loss of body weight during primary therapy is an indicator for poor OS; weight gain is an indicator for improved survival. This study supports the development of strategies to minimize weight loss that can be assessed in a prospective, randomized study to improve patient outcomes.
AB - Objective: Platinum/Paclitaxel-based chemotherapy is a current treatment for advanced epithelial ovarian cancer. We sought to explore the association between weight change during treatment and survival, as well as the association between pre-chemotherapy body mass index (BMI) and survival. Methods: A retrospective data review was conducted of 792 advanced ovarian cancer patients who participated in a phase III randomized trial of cisplatin/paclitaxel versus carboplatin/paclitaxel. Pre-chemotherapy BMI was calculated following surgery. Weight change was defined as the ratio of body weight at completion of protocol therapy to pre-chemotherapy body weight. Progression-free survival (PFS) and overall survival (OS), classified by BMI or relative weight change, were estimated by Kaplan-Meier, and associations were assessed using a Cox model controlled for known prognostic variables (age, race, performance status, histology, tumor grade, tumor residual and treatment group). Results: There was no association between pre-chemotherapy BMI and survival. There was a significant relationship between median OS and weight change as follows: > 5% decrease = 48.0 months; 0-5% decrease = 49.3 months; 0-5% increase = 61.1 months; and > 5% increase = 68.2 months. Adjusted for covariates, the relative risk of death increased by 7% for each 5% decrease in body weight (HR = 0.93, 95% CI = 0.88-0.99; p = 0.013). Conclusions: Change of body weight during primary chemotherapy was a strong prognostic factor for overall survival. Loss of body weight during primary therapy is an indicator for poor OS; weight gain is an indicator for improved survival. This study supports the development of strategies to minimize weight loss that can be assessed in a prospective, randomized study to improve patient outcomes.
KW - BMI
KW - Body weight
KW - Chemotherapy
KW - Ovarian cancer
KW - Survival
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U2 - 10.1016/j.ygyno.2007.06.010
DO - 10.1016/j.ygyno.2007.06.010
M3 - Article
C2 - 17675142
AN - SCOPUS:35348833746
VL - 107
SP - 260
EP - 265
JO - Gynecologic Oncology
JF - Gynecologic Oncology
SN - 0090-8258
IS - 2
ER -