The association between CT scan-based body composition measurements and high grade serous ovarian cancer outcomes Open Access

Abstract

Objective

To evaluate the association between high grade serous ovarian cancer (HGSOC) outcomes (overall survival and disease recurrence) and computed tomography (CT) scan-based body composition measurements (visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT), intermuscular adipose tissue (IMAT), and skeletal muscle index (SMI)).

 

Methods

A retrospective review was conducted using electronic medical records from Emory University Hospital to find pre-treatment CT-scans, vital status, and recurrence status for each participant. The CT-scans were quantified into surface area measurements and multivariate cox proportional hazards models and accelerated time to failure models with a Weibull distribution were utilized to calculate hazard ratios. The association between obesity and HGSOC outcomes were fit stratified by low and high body composition levels. A meta-analysis was conducted with data from the present study in combination with Moffitt Cancer Center and Roswell Park Comprehensive Cancer Institute.

 

Results

In the multivariate survival analysis, VAT was statistically significantly associated with longer time to recurrence (HR = 0.42, 95% CI (0.19, 0.99)). Obesity was significantly associated with overall survival among those with higher SAT area (HR = 0.23, 95% CI (0.07, 0.81)). The results of our meta-analysis revealed evidence of a dose-response for overall survival and VAT area. Medium VAT area suggested greater survival while high VAT area suggested poorer survival (HR = 0.76, 95% CI (0.33, 1.77) and HR = 1.10 (0.87, 1.39), respectively).

 

Conclusion

Future studies need to be conducted to better understand the relationship between CT scan-based body composition measurements and HGSOC outcomes. Missingness of data from electronic medical records needs to be addressed and a larger sample size is necessary to properly understand this relationship.

Table of Contents

Introduction, 1-9

Table 1 - page 6

Methods, 9-13

Figure 1- page 11

Results, 13-22

Figure 2- page 14 Table 2- page 15-16 Table 3- page 17 Figure 3- page 18 Table 4- page 19 Table 5- page 21 Table 6- page 22

Discussion, 23-26

References. 27-31

About this Master's Thesis

Rights statement

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School	Rollins School of Public Health
Department	Epidemiology
Degree	M.P.H.
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Epidemiology
Keyword	overall survival High grade serous ovarian cancer Body Composition CT scans recurrence
Committee Chair / Thesis Advisor	Joellen Schildkraut, Emory University

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