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

 Young Song  ;  Myung Il Bae  ;  Dong Woo Han  ;  Eun Jung Park  ;  Sujung Park  ;  Sung Yeon Ham 
 WORLD JOURNAL OF SURGICAL ONCOLOGY, Vol.21(1) : 345, 2023-10 
Journal Title
Issue Date
Antineoplastic Combined Chemotherapy Protocols / therapeutic use ; Combined Modality Therapy ; Cytoreduction Surgical Procedures / adverse effects ; Humans ; Hyperthermia, Induced* ; Hyperthermic Intraperitoneal Chemotherapy ; Peritoneal Neoplasms* / pathology ; Postoperative Complications / etiology ; Prognosis ; Retrospective Studies ; Survival Rate
Bioelectrical impedance analysis ; Hyperthermic intraperitoneal chemotherapy ; Prognosis
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.
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1. College of Medicine (의과대학) > Dept. of Anesthesiology and Pain Medicine (마취통증의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Park, Sujung(박수정) ORCID logo https://orcid.org/0000-0002-2249-3286
Park, Eun Jung(박은정) ORCID logo https://orcid.org/0000-0002-4559-2690
Bae, Myung Il(배명일)
Song, Young(송영) ORCID logo https://orcid.org/0000-0003-4597-387X
Han, Dong Woo(한동우) ORCID logo https://orcid.org/0000-0002-8757-663X
Ham, Sung Yeon(함성연) ORCID logo https://orcid.org/0000-0001-8619-4595
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