The comparison of the prognostic value of scored patient generated subjective global assessment and Computed Tomography measured sarcopenia in patients with gynecological cancer

• DOI: 10.1016/j.clnesp.2022.02.004
• Publication Date: 2022-02-15T03:40:30Z
• Authors: Sehnaz Evrimler; Serhan Can Iscan; Gokce Iscan; Jalal Raoufi; Evrim Erdemoglu
• Keywords: 2. Zero hunger; Sarcopenia; 03 medical and health sciences; 0302 clinical medicine; Neoplasms; Malnutrition; Humans; Prognosis; Tomography, X-Ray Computed; 3. Good health

Screening of the nutrition status is recommended for the early detection and treatment of cancer-associated malnutrition to improve the prognosis. We aimed to compare the prognostic value of Patient Generated-Subjective Global Assessment (PG-SGA) and CT measured sarcopenia in patients with gynecological cancer.A total of 107 patients of which were 57 endometrial, 37 ovarian, and 13 cervical cancer who underwent surgery and evaluated by PG-SGA were enrolled. Skeletal muscle index (SMI) was calculated by automatic segmentation of the muscle area at the L3 level on abdominal CT scan and defined by the cut-off value of 38.9 cm2/m2. Karnofsky and Eastern Cooperative Oncology Group (ECOG) Performance Status scorings were performed. Hospitalization length (HL), overall- (OS), and progression-free- survival (PFS) were analyzed. Body muscle index (BMI) (kg/m2) was calculated. Serum CA-125 and albumin levels were obtained.The prevalence of malnutrition and sarcopenia were 67% and 26.2%, respectively. BMI was significantly associated with PG-SGA (p = 0.02) and SMI (p = 0.01). PG-SGA significantly correlated with CA-125 (r = 0.33, p = 0.002), ECOG (r = 0.29, p = 0.002), Karnofsky (r = -0.34, p < 0.001), and HL (r = 0.27, p = 0.004). PG-SGA showed a significant association with PFS (p = 0.007) and OS (p = 0.001). PG-SGA≥9 showed a significant relationship with prolonged HL, mortality, and progression (OR = 1.08; p = 0.03, OR = 23.09; p = 0.003, and OR = 5.39; p = 0.001, respectively).PG-SGA can identify patients at nutritional risk earlier than SMI. PG-SGA shows a higher correlation with HL and clinical performance scores than SMI. PG-SGA is a better prognostic factor for prolonged HL, OS, and PFS.