Core muscle index (CMI) and co-morbidities are integral in assessing patient frailty. We explored the effect of age, CMI and Age-Adjusted Charlson Comorbidity Index (ACCI) on postoperative clinical outcomes in patients with epithelial ovarian cancer (EOC).METHODS:
Stage III–IV EOC following primary cytoreductive surgery (CRS) from 2007–2005 were included. Computed tomography was used to determine psoas muscle cross-sectional area at L4 (cm2) and normalized for height (m2) to determine the CMI. “Sarcopenia” was defined as below the mean value of CMI. Clinical and survival outcomes were assessed and compared.RESULTS:
104 women underwent primary CRS. Median age was 53 yrs (range 23–77) and median follow-up was 26.5 months (range 1–85). High-grade serous comprised 74% of all histologies. Age 65 and older was significantly associated with worse median overall survival (28 mo v 66 mo, P=.018), but not progression free survival (16 mo v 16 mo, P=.73). Age did not affect short-term morbidity (P=.29). Mean CMI was 4.56±0.13 cm2/m2. There was no association between CMI and survival even when patients 65 yrs and older were excluded. CMI was not a predictor of short-term morbidity. Excluding 65 yrs and older, patients with sarcopenia had a shorter mean hospital stay (P=.005), and sarcopenia was associated with ACCI (P=.008). ACCI did not influence survival or short-term morbidity (P=.06).CONCLUSION:
Age is the only frailty index associated with overall survival among patients who are candidates for CRS. Although age, CMI and ACCI did not influence short-term morbidity, sarcopenia was associated with ACCI and shorter hospital stay.