Impact of Body Mass Index (BMI) on Chemotherapy-associated Toxicity in Ovarian Cancer Patients. A Pooled Analysis of the North-Eastern German Society of Gynecological Oncology (NOGGO) Databank on 1,213 Patients.

BACKGROUND/AIM: Chemotherapy-associated toxicity is one of the limiting factors regarding treatment efficacy, patient outcome and quality of life in this collective. Underweight or obese patients represent a major group in which the therapy seems to be more challenging. The aim of this analysis was to evaluate the impact of BMI on the toxicity in patients undergoing chemotherapy. PATIENTS AND METHODS: The data of three prospective phase II/III studies ('Tower', 'Topotecan phase III' and 'Hector') of the North-Eastern German Society of Gynecological Oncology including 1,213 patients with recurrent ovarian cancer were retrospectively analyzed. The study was performed using logistic regression and Cox regression analysis. RESULTS: The median age at diagnosis was 59 years. Sixty-seven (5.5%) patients had BMI <20 and 272 (22.4%) patients had BMI >30. Preterm termination of the chemotherapy was associated with lower BMI (p=0.017). Moreover, non-hematological toxicity grade III/IV was mainly observed in underweighted women as well (p<0.001). Patients with higher BMI more often presented with grade III/IV anemia (p=0.019) and as a consequence required blood transfusions more frequently (p=0.005). The overweight group was also associated with a higher number of co-medications. However, no difference in survival regarding BMI was observed in our study. CONCLUSION: Fewer chemotherapy cycles and preterm discontinuation were more frequent in patients with lower BMI. Hematological toxicity and higher medication intake appeared more often in patients with higher BMI.

Evaluation of leptin serum concentrations during surgery and first-line chemotherapy in primary epithelial ovarian cancer patients.

AIM OF THE STUDY: The available data on serum leptin levels in ovarian cancer present contradictory results. The majority of authors report lower leptin levels in those patients in comparison to healthy individuals. However, there is no data regarding leptin concentrations during therapy in women with primary epithelial ovarian cancer. MATERIAL AND METHODS: Blood samples were collected at the time of diagnosis, after initial surgery, and after first-line chemotherapy. Leptin serum concentrations were analysed using ELISA technique. Additionally, parallel measurements of CA125 levels were performed. RESULTS: Fifty-three patients with primary epithelial ovarian cancer met the inclusion criteria and were included in our study. Our analysis revealed a significant difference in mean preoperative serum leptin concentrations between early and advanced ovarian cancer patients (p < 0.0001). We identified statistically significant elevation of mean serum leptin levels (p < 0.001) after complete macroscopic cytoreduction and after first-line chemotherapy in advanced ovarian cancer cases. DISCUSSION: In this cohort, a significant elevation of postoperative serum leptin levels after complete macroscopic cytoreduction were shown. Moreover, elevation of leptin levels corresponded with remission after chemotherapy. Further studies are needed to determine if leptin can be a potential marker of surgery completeness as well as a marker in chemotherapy response evaluation.