High-radiodensity skeletal index as predictor of early mortality in ovarian adenocarcinoma

Abstract

Purpose: to determine the prognostic value of the quantitative and qualitative parameters of the skeletal muscle in patients with ovarian adenocarcinoma. Methods: In a retrospective cohort, we included patients with ovarian adenocarcinoma, enrolled between 2008-2015, who had a computerized tomography (CT) scan available within 45 days before any cancer treatment. Sociodemographic and clinical data were collected, as well as one-year survival. CT images at the third lumbar vertebra (L3) were used to assess overall skeletal muscle index (SMI), which was afterwards divided into sub-ranges of radiation attenuation: low radiodensity skeletal muscle index (LRSMI) and high-radiodensity skeletal muscle index (HRSMI). Sarcopenia was defined when SMI was ≤ 38.9 cm²/m². Kaplan-Meier method and Cox Regression evaluated one-year survival. Results: sarcopenia was found in 34.5% of the 139 eligible patients, although it was not associated to one-year survival. Patients in the lower quartile of the HRSMI had a shorter survival time, compared to patients in the upper quartiles (p = 0.014). In multiple cox regression, HRSMI was the only independent predictor of shorter survival (HR: 2.852; CI: 1.17-6.95, p = 0.021). Conclusion: these results indicate that skeletal muscle quality, specifically the amount of HRSMI, directly implies in poor prognosis of patients with ovarian adenocarcinoma. More studies are needed to understand the role of the HRSMI in cancer outcomes.