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EP1009 Loss of skeletal muscle mass during neo-adjuvant chemotherapy and the relation to survival in patients with ovarian cancer; a prospective analysis of the OVHIPEC-1 cohort
  1. J Ubachs1,2,3,
  2. S Koole4,5,6,
  3. L Bruijs4,
  4. M Lahaye7,
  5. C Fabris8,
  6. J Schagen van Leeuwen9,
  7. H Schreuder10,
  8. R Hermans11,
  9. I de Hingh12,
  10. J van der Velden6,13,
  11. H Arts14,
  12. L Massuger15,
  13. J Bastings1,
  14. R Kruitwagen1,2,
  15. S Lambrechts1,2,
  16. S Olde Damink3,16,17,
  17. S Rensen3,16,
  18. T van Gorp18,
  19. G Sonke5,6,19 and
  20. W van Driel4,6,19
  1. 1Department of Obstetrics and Gynecology, Maastricht University Medical Centre (MUMC)
  2. 2GROW – School for Oncology and Developmental Biology
  3. 3Department of Surgery, Maastricht University Medical Centre (MUMC), Maastricht
  4. 4Department of Gynecology
  5. 5Department of Medical Oncology, The Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital
  6. 6Center for Gynecologic Oncology Amsterdam
  7. 7Department of Radiology, The Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
  8. 8Department of Radiology, University of Verona Hospital, Verona, Italy
  9. 9Department of Obstetrics and Gynecology, Sint Antonius Hospital, Nieuwegein
  10. 10Department of Gynecological Oncology, UMC Utrecht Cancer Center, University Medical Center Utrecht, Utrecht University, Utrecht
  11. 11Department of Gynecology and Obstetrics
  12. 12Department of Surgery, Catharina Hospital, Eindhoven
  13. 13Department of Obstetrics and Gynecology, Amsterdam UMC, Location AMC, Amsterdam
  14. 14Department of Gynecological Oncology, University Medical Center Groningen, Groningen
  15. 15Department of Gynecological Oncology, Radboud University Medical Center, Nijmegen
  16. 16NUTRIM, School of Nutrition and Translational Research in Metabolism, Maastricht, The Netherlands
  17. 17Department of Visceral- and Transplantation Surgery, RWTH Aachen University, Aachen, Germany
  18. 18Department of Obstetrics and Gynecology, Division of Gynecological Oncology, University Hospitals Leuven, Leuven Cancer Institute, Leuven, Belgium
  19. 19Dutch Gynecological Oncology Group, The Netherlands, The Netherlands


Introduction/Background Skeletal muscle depletion in women with advanced ovarian cancer has been associated with adverse clinical outcome and survival. To validate earlier results in a homogenous population, we analyzed whether a decrease in skeletal muscle index (SMI) during neo-adjuvant chemotherapy (NACT) is associated with worse outcome in patients with stage III epithelial ovarian cancer, who were included in the OVHIPEC trial.

Methodology Within the phase III OVHIPEC trial, 245 patients with stage III ovarian cancer were randomized after three cycles of NACT with carboplatin and paclitaxel to receive interval cytoreductive surgery (CRS) with or without HIPEC. Randomization was performed after at least stable disease after two cycles of NACT, and when complete or optimal CRS was achieved. CT-scans performed at baseline (timepoint 1), and after two cycles of NACT (timepoint 2) were selected. A slide on the third lumbar level was selected from each CT-scan, and the difference in SMI between both scans (ΔSMI) was calculated using SliceOMatic. Overall and recurrence-free survival of patients with a decrease or increase in ΔSMI were performed using Kaplan-Meier estimates and log-rank tests.

Results Of the 245 patients randomized in the OVHIPEC trial, SMI and ΔSMI of scans at both timepoints were available for 212 patients (87%). After a median follow-up of 4.7 years, 116 of 212 patients (55%) had died. In survival analysis, 43 of 74 patients (58%) in the group with a decrease in ΔSMI, and 73 of 138 of the patients (53%) in the group with stable/increase in ΔSMI had died. Median overall survival did not differ significantly(p=0.764).

Conclusion A decreasing skeletal muscle index during neo-adjuvant chemotherapy was not associated with worse outcome in patients with stage III ovarian cancer, who were treated with complete/optimal interval CRS and six cycles of chemotherapy within the OVHIPEC trial.

Disclosure Nothing to disclose.

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