TY - JOUR
T1 - Association between Energy Balance-Related Factors and Clinical Outcomes in Patients with Ovarian Cancer
T2 - A Systematic Review and Meta-Analysis
AU - Stelten, Stephanie
AU - Schofield, Christelle
AU - Hartman, Yvonne A. W.
AU - Lopez, Pedro
AU - Kenter, Gemma G.
AU - Newton, Robert U.
AU - Galvão, Daniel A.
AU - Hoedjes, Meeke
AU - Taaffe, Dennis R.
AU - van Lonkhuijzen, Luc R. C. W.
AU - McIntyre, Carolyn
AU - Buffart, Laurien M.
N1 - Publisher Copyright: © 2022 by the authors.
PY - 2022/10/1
Y1 - 2022/10/1
N2 - Background: This systematic review and meta-analysis synthesized evidence in patients with ovarian cancer at diagnosis and/or during first-line treatment on; (i) the association of body weight, body composition, diet, exercise, sedentary behavior, or physical fitness with clinical outcomes; and (ii) the effect of exercise and/or dietary interventions. Methods: Risk of bias assessments and best-evidence syntheses were completed. Meta-analyses were performed when ≥3 papers presented point estimates and variability measures of associations or effects. Results: Body mass index (BMI) at diagnosis was not significantly associated with survival. Although the following trends were not supported by the best-evidence syntheses, the meta-analyses revealed that a higher BMI was associated with a higher risk of post-surgical complications (n = 5, HR: 1.63, 95% CI: 1.06–2.51, p = 0.030), a higher muscle mass was associated with a better progression-free survival (n = 3, HR: 1.41, 95% CI: 1.04–1.91, p = 0.030) and a higher muscle density was associated with a better overall survival (n = 3, HR: 2.12, 95% CI: 1.62–2.79, p < 0.001). Muscle measures were not significantly associated with surgical or chemotherapy-related outcomes. Conclusions: The prognostic value of baseline BMI for clinical outcomes is limited, but muscle mass and density may have more prognostic potential. High-quality studies with comprehensive reporting of results are required to improve our understanding of the prognostic value of body composition measures for clinical outcomes. Systematic review registration number: PROSPERO identifier CRD42020163058.
AB - Background: This systematic review and meta-analysis synthesized evidence in patients with ovarian cancer at diagnosis and/or during first-line treatment on; (i) the association of body weight, body composition, diet, exercise, sedentary behavior, or physical fitness with clinical outcomes; and (ii) the effect of exercise and/or dietary interventions. Methods: Risk of bias assessments and best-evidence syntheses were completed. Meta-analyses were performed when ≥3 papers presented point estimates and variability measures of associations or effects. Results: Body mass index (BMI) at diagnosis was not significantly associated with survival. Although the following trends were not supported by the best-evidence syntheses, the meta-analyses revealed that a higher BMI was associated with a higher risk of post-surgical complications (n = 5, HR: 1.63, 95% CI: 1.06–2.51, p = 0.030), a higher muscle mass was associated with a better progression-free survival (n = 3, HR: 1.41, 95% CI: 1.04–1.91, p = 0.030) and a higher muscle density was associated with a better overall survival (n = 3, HR: 2.12, 95% CI: 1.62–2.79, p < 0.001). Muscle measures were not significantly associated with surgical or chemotherapy-related outcomes. Conclusions: The prognostic value of baseline BMI for clinical outcomes is limited, but muscle mass and density may have more prognostic potential. High-quality studies with comprehensive reporting of results are required to improve our understanding of the prognostic value of body composition measures for clinical outcomes. Systematic review registration number: PROSPERO identifier CRD42020163058.
KW - body composition
KW - diet
KW - exercise
KW - meta-analysis
KW - ovarian cancer
UR - http://www.scopus.com/inward/record.url?scp=85139827010&partnerID=8YFLogxK
U2 - https://doi.org/10.3390/cancers14194567
DO - https://doi.org/10.3390/cancers14194567
M3 - Review article
C2 - 36230490
SN - 2072-6694
VL - 14
JO - Cancers
JF - Cancers
IS - 19
M1 - 4567
ER -