{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T17:51:55Z","timestamp":1790790715934,"version":"4.1.0"},"reference-count":45,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2021,2,4]],"date-time":"2021-02-04T00:00:00Z","timestamp":1612396800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J cachexia sarcopenia muscle"],"published-print":{"date-parts":[[2021,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>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.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>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 \u2018Up and Go\u2019 test, performed hand grip strength, and calculated a skeletal muscle index. Postoperative complications were categorized using Clavien\u2013Dindo Classification. Utilizing ROC analysis and logistic regression, we determined predictive clinical factors for severe postoperative complications. Kaplan\u2013Meier method and log\u2010rank test were used for overall survival analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the 226 female patients, 120 (53%) had a BMI\u00a0\u2265\u00a025\u00a0kg\/m<jats:sup>2<\/jats:sup>, 56 (26%) had a phase angle\u00a0&lt;\u00a04.75\u00b0, and 68 (32%) were sarcopenic according to skeletal muscle index\u00a0&lt;\u00a027%. Within 30\u00a0days after surgery, 40 (18%) patients developed severe postoperative complications, and 4% had died. According to multivariable regression analysis, ECOG status\u00a0&gt;\u00a01 (OR 4.56, 95% CI: 1.46\u201314.28, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.009), BMI\u00a0\u2265\u00a025\u00a0kg\/m<jats:sup>2<\/jats:sup> (OR 8.22, 95% CI: 3.01\u201322.48, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001), phase angle\u00a0&lt;\u00a04.75\u00b0 (OR 3.95, 95% CI: 1.71\u20139.10, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.001), and tumour stage\u00a0\u2265\u00a0III A (OR 3.65, 95% CI: 1.36\u20139.76, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.01) were predictors of severe postoperative complications. During 59\u00a0months of follow\u2010up, 108 (48%) patients had died. According to multivariable Cox regression ECOG status\u00a0&gt;\u00a01 (HR 2.51, 95% CI: 1.25\u20135.03, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.01), hypoalbuminemia (HR 2.15, 95% CI: 1.28\u20133.59, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.004), phase angle\u00a0&lt;\u00a04.5\u00b0 (HR 1.76, 95% CI 1.07\u20132.90, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.03), tumour stage\u00a0\u2265\u00a0III A (HR 2.61, 95% CI: 1.53\u20134.45, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001), and severe postoperative complications (HR 2.82, 95% CI: 1.80\u20134.41, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001) were predictors of overall mortality.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>We observed that preoperatively assessed ECOG status\u00a0&gt;\u00a01, BMI\u00a0&gt;\u00a025\u00a0kg, as well as phase angle alpha\u00a0&lt;\u00a04.75\u00b0 and FIGO stage\u00a0\u2265\u00a0III A are significantly associated with severe postoperative complications within the first month. Whereas ECOG status\u00a0&gt;\u00a01, hypoalbuminemia, phase angle\u00a0&lt;\u00a04.5\u00b0 as well as FIGO stage\u00a0\u2265\u00a0III A and severe postoperative complications within 30\u00a0days correlate significantly with poor overall survival.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jcsm.12676","type":"journal-article","created":{"date-parts":[[2021,2,8]],"date-time":"2021-02-08T02:09:12Z","timestamp":1612750152000},"page":"393-402","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":50,"title":["Effects of sarcopenia and malnutrition on morbidity and mortality in gynecologic cancer surgery: results of a prospective study"],"prefix":"10.1002","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5963-6623","authenticated-orcid":false,"given":"Jalid","family":"Sehouli","sequence":"first","affiliation":[{"name":"Department of Gynecology, European Competence Center for Ovarian Cancer, Berlin, Germany Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin, corporate member of Freie Universit\u00e4t Berlin, Humboldt\u2010Universit\u00e4t zu Berlin, and Berlin Institute of Health  Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0316-8648","authenticated-orcid":false,"given":"Kristina","family":"Mueller","sequence":"additional","affiliation":[{"name":"Department of Gynecology, European Competence Center for Ovarian Cancer, Berlin, Germany Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin, corporate member of Freie Universit\u00e4t Berlin, Humboldt\u2010Universit\u00e4t zu Berlin, and Berlin Institute of Health  Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2965-8730","authenticated-orcid":false,"given":"Rolf","family":"Richter","sequence":"additional","affiliation":[{"name":"Department of Gynecology, European Competence Center for Ovarian Cancer, Berlin, Germany Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin, corporate member of Freie Universit\u00e4t Berlin, Humboldt\u2010Universit\u00e4t zu Berlin, and Berlin Institute of Health  Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Markus","family":"Anker","sequence":"additional","affiliation":[{"name":"Division of Cardiology and Metabolism, Department of Cardiology (CVK) Charit\u00e9 Universit\u00e4tsmedizin Berlin  Berlin Germany"},{"name":"Berlin Institute of Health Center for Regenerative Therapies (BCRT)  Berlin Germany"},{"name":"DZHK (German Centre for Cardiovascular Research), partner site Berlin  Berlin Germany"},{"name":"Department of Cardiology (CBF) Charit\u00e9 Universit\u00e4tsmedizin Berlin  Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8617-5535","authenticated-orcid":false,"given":"Hannah","family":"Woopen","sequence":"additional","affiliation":[{"name":"Department of Gynecology, European Competence Center for Ovarian Cancer, Berlin, Germany Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin, corporate member of Freie Universit\u00e4t Berlin, Humboldt\u2010Universit\u00e4t zu Berlin, and Berlin Institute of Health  Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4529-8387","authenticated-orcid":false,"given":"Julia","family":"Rasch","sequence":"additional","affiliation":[{"name":"Department of Gynecology, European Competence Center for Ovarian Cancer, Berlin, Germany Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin, corporate member of Freie Universit\u00e4t Berlin, Humboldt\u2010Universit\u00e4t zu Berlin, and Berlin Institute of Health  Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacek P.","family":"Grabowski","sequence":"additional","affiliation":[{"name":"Department of Gynecology, European Competence Center for Ovarian Cancer, Berlin, Germany Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin, corporate member of Freie Universit\u00e4t Berlin, Humboldt\u2010Universit\u00e4t zu Berlin, and Berlin Institute of Health  Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eva","family":"Prinz\u2010Theissing","sequence":"additional","affiliation":[{"name":"Department of Gynecology, European Competence Center for Ovarian Cancer, Berlin, Germany Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin, corporate member of Freie Universit\u00e4t Berlin, Humboldt\u2010Universit\u00e4t zu Berlin, and Berlin Institute of Health  Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3871-7440","authenticated-orcid":false,"given":"Melisa Guelhan","family":"Inci","sequence":"additional","affiliation":[{"name":"Department of Gynecology, European Competence Center for Ovarian Cancer, Berlin, Germany Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin, corporate member of Freie Universit\u00e4t Berlin, Humboldt\u2010Universit\u00e4t zu Berlin, and Berlin Institute of Health  Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,2,4]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.acuro.2017.05.004"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40644-019-0270-0"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/afy212"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000000628"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/jso.24025"},{"key":"e_1_2_8_7_1","unstructured":"Sarcopenia: revised European consensus on definition and diagnosis.https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC6322506\/. Accessed December 12 2019."},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-2006-924953"},{"key":"e_1_2_8_9_1","doi-asserted-by":"crossref","unstructured":"Lardi\u00e9s\u2010S\u00e1nchezB Sanz\u2010Par\u00edsASarcopenia and malnutrition in the elderly. Frailty Sarcopenia \u2010 Onset Dev Clin Chall. August 2017.https:\/\/doi.org\/10.5772\/intechopen.68426","DOI":"10.5772\/intechopen.68426"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1201\/b19985-4"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eurger.2015.12.010"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0169548"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejon.2005.09.001"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.ejcn.1602540"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00404-010-1659-y"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/jcsm.12468"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygyno.2013.08.011"},{"key":"e_1_2_8_18_1","first-page":"3673","article-title":"Inflammatory and nutritional serum markers as predictors of peri\u2010operative morbidity and survival in ovarian cancer","volume":"37","author":"Kumar A","year":"2017","journal-title":"Anticancer Res"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0140403"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygyno.2016.05.027"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-2003-41864"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.sla.0000133083.54934.ae"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0030-1248434"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1152\/jappl.2000.89.2.465"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1532-5415.2002.50216.x"},{"key":"e_1_2_8_26_1","first-page":"272","article-title":"Malnutrition: laboratory markers vs nutritional assessment","volume":"4","author":"Bharadwaj S","year":"2016","journal-title":"Gastroenterol Rep"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.5468\/ogs.2015.58.5.359"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygyno.2015.07.005"},{"key":"e_1_2_8_29_1","doi-asserted-by":"publisher","DOI":"10.1006\/gyno.2001.6353"},{"key":"e_1_2_8_30_1","doi-asserted-by":"publisher","DOI":"10.2147\/CMAR.S161876"},{"key":"e_1_2_8_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygyno.2010.09.010"},{"key":"e_1_2_8_32_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.13585"},{"key":"e_1_2_8_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygyno.2014.07.103"},{"key":"e_1_2_8_34_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygyno.2014.01.041"},{"key":"e_1_2_8_35_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jmig.2014.07.014"},{"key":"e_1_2_8_36_1","doi-asserted-by":"publisher","DOI":"10.1038\/ejcn.2015.126"},{"key":"e_1_2_8_37_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2016.34.15_suppl.5574"},{"key":"e_1_2_8_38_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygyno.2018.03.044"},{"key":"e_1_2_8_39_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clnu.2005.05.005"},{"key":"e_1_2_8_40_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.28624"},{"key":"e_1_2_8_41_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0899-9007(99)00230-0"},{"key":"e_1_2_8_42_1","doi-asserted-by":"publisher","DOI":"10.1093\/ajcn\/80.6.1634"},{"key":"e_1_2_8_43_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-018-6683-3"},{"key":"e_1_2_8_44_1","unstructured":"ECOG Performance Status.ECOG\u2010ACRIN.https:\/\/ecog-acrin.org\/resources\/ecog-performance-status. Accessed March 12 2020."},{"key":"e_1_2_8_45_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jgo.2020.09.029"},{"key":"e_1_2_8_46_1","doi-asserted-by":"publisher","DOI":"10.1002\/jcsm.12501"}],"container-title":["Journal of Cachexia, Sarcopenia and Muscle"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jcsm.12676","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/jcsm.12676","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jcsm.12676","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,19]],"date-time":"2023-08-19T21:10:45Z","timestamp":1692479445000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jcsm.12676"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,2,4]]},"references-count":45,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2021,4]]}},"alternative-id":["10.1002\/jcsm.12676"],"URL":"https:\/\/doi.org\/10.1002\/jcsm.12676","archive":["Portico"],"relation":{},"ISSN":["2190-5991","2190-6009"],"issn-type":[{"value":"2190-5991","type":"print"},{"value":"2190-6009","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,2,4]]},"assertion":[{"value":"2020-05-06","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-12-23","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-02-04","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}