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World Journal of Surgical Oncology
Published in: World Journal of Surgical Oncology 1/2023

Open Access 01-12-2023 | Peritoneal Cancer | Research

Prognostic role of body composition in peritoneal carcinomatosis patients undergoing cytoreduction and hyperthermic intraperitoneal chemotherapy

Authors: Young Song, Myung Il Bae, Dong Woo Han, Eun Jung Park, Sujung Park, Sung Yeon Ham

Published in: World Journal of Surgical Oncology | Issue 1/2023

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Abstract

Background

Bioelectric impedance analysis (BIA)-measured body composition and nutritional status have been used as prognostic indicators in various cancer cohorts. This study investigated whether BIA could provide information on prognosis in peritoneal carcinomatosis patients undergoing cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC).

Methods

We retrospectively analyzed the data of 99 patients with preoperative BIA data among those who underwent CRS and HIPEC. The association between BIA-derived parameters and intraoperative peritoneal cancer index (PCI) score was assessed. Predictive analysis for the occurrence of postoperative morbidities including major complications (Clavien–Dindo classification 3–4) and re-admission within 30 days after surgery as well as 1 year mortality was also performed.

Results

BIA-derived mineral (r = 0.224, p = 0.027), fat (r =  − 0.202, p = 0.048), and total body water (TBW)/fat-free mass (FFM) (r =  − 0.280, p = 0.005) showed significant associations with intraoperative PCI score. Lower TBW/FFM was an independent predictor of major postoperative complications (OR 0.047, 95% CI 0.003–0.749, p = 0.031) and re-admission (OR 0.094, 95% CI 0.014–0.657, p = 0.017) within 30 days after surgery. Higher fat mass was also independently associated with a higher risk of major postoperative complications (OR 1.120, 95% CI 1.006–1.248, p = 0.039) and re-admission (OR 1.123, 95% CI 1.024–1.230, p = 0.013). Intraoperative PCI score > 20 (OR 4.489, 95% CI 1.191–16.917, p = 0.027) and re-admission within 30 days after surgery (OR 5.269, 95% CI 1.288–21.547, p = 0.021) independently predicted postoperative 1-year mortality.

Conclusions

We demonstrate that preoperative BIA-derived TBW/FFM and fat mass were significantly correlated with metastatic extent, assessed by PCI score, in patients with peritoneal carcinomatosis. In addition, BIA-derived TBW/FFM and fat mass showed independent predictability for postoperative 30-day major complications and re-admission in patients undergoing CRS and HIPEC. Our findings suggest that assessment of BIA may improve discrete risk stratification in patients who are planned to receive CRS and HIPEC.
Appendix
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Metadata
Title
Prognostic role of body composition in peritoneal carcinomatosis patients undergoing cytoreduction and hyperthermic intraperitoneal chemotherapy
Authors
Young Song
Myung Il Bae
Dong Woo Han
Eun Jung Park
Sujung Park
Sung Yeon Ham
Publication date
01-12-2023
Publisher
BioMed Central
Published in
World Journal of Surgical Oncology / Issue 1/2023
Electronic ISSN: 1477-7819
DOI
https://doi.org/10.1186/s12957-023-03233-0

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