Effects of sarcopenia and malnutrition on morbidity and mortality in gynecologic cancer surgery: results of a prospective study

Abstract

Abstract Background Malnutrition and sarcopenia often occur simultaneously in cancer patients and are thought to have harmful effects on both surgical and oncological outcomes. Therefore, we want to evaluate the effects of sarcopenia and malnutrition on severe postoperative complications and overall survival in gynecologic cancer patients. Methods We assessed nutritional parameters and run a bioelectrical impedance analysis in 226 women. Extracellular mass to body cell mass index, phase angle alpha, muscle mass, and fat mass were evaluated. To determine if patients suffer from sarcopenia, we ran the Timed ‘Up and Go’ test, performed hand grip strength, and calculated a skeletal muscle index. Postoperative complications were categorized using Clavien–Dindo Classification. Utilizing ROC analysis and logistic regression, we determined predictive clinical factors for severe postoperative complications. Kaplan–Meier method and log‐rank test were used for overall survival analysis. Results Of the 226 female patients, 120 (53%) had a BMI ≥ 25 kg/m2, 56 (26%) had a phase angle 1 (OR 4.56, 95% CI: 1.46–14.28, P = 0.009), BMI ≥ 25 kg/m2 (OR 8.22, 95% CI: 3.01–22.48, P 1 (HR 2.51, 95% CI: 1.25–5.03, P = 0.01), hypoalbuminemia (HR 2.15, 95% CI: 1.28–3.59, P = 0.004), phase angle 1, BMI > 25 kg, as well as phase angle alpha 1, hypoalbuminemia, phase angle < 4.5° as well as FIGO stage ≥ III A and severe postoperative complications within 30 days correlate significantly with poor overall survival.

Keywords

• Sarcopenia
• Malnutrition
• Postoperative complications
• Gynecologic oncology
• Overall survival