#208 Metabolic syndrome, long-term fatigue and inflammation in epithelial ovarian cancer survivors: vivrovaire, ancillary study

Introduction/Background

Quality of life (QOL) after treatments, notably long-term fatigue (LTF) is a major concern for epithelial ovarian cancer survivors (EOCs). Metabolic syndrome (MetS) was shown to be associated with cancer survivorship and fatigue. Inflammation was also demonstrated to be related with fatigue in cancer patients, but few studies explored LTF. We aimed to evaluate the association between LTF, MetS and inflammation among EOCs.

Methodology

The VIVROVAIRE study enrolled EOCs free of relapse ≥ 3 years after treatments in 11 French GINECO centers. Fatigue was assessing using FACIT-F-TOI (including fatigue and physical/functional dimensions of the FACT-G) self-questionnaires. MetS was estimated by the International Diabetes Federation definition. Blood cytokines (IFN-γ, IL-10, IL-18, IL1-RA, IL-6, IL-8, IL1-β and TNF-α) were measured by enzyme-linked immunosorbent assay. Univariate, multivariate regression analyses and mediation analysis were performed, with a statistical significant of p ≤ 0,01.

Results

Analyses concern 143 EOCs: median age at inclusion, 63 years [range, 55–70], median delay from end of treatment, 5 years [range, 3–7]. Prevalence of MetS was 22% (31 patients). EOCS with MetS had poorer FACIT-F-TOI score than non-MetS EOCS (75 vs 87, p = 0.001). Elevation of IL1-RA and IL-6 expressions was significantly associated with MetS in univariate (p <0.001 and p = 0.002, respectively) and multivariate regression analyses (p <0.001 and p = 0.008). IL1-RA was also associated with the FACIT-F-TOI in uni and multivariate analysis (p <0,001). The mediation analysis performed showed IL1-RA produced an average causal mediation between FACIT-F-TOI score and MetS (p = 0,008) with a significant proportion of mediated effect (41%, p = 0,01).

Conclusion

EOCs with MetS present more LTF than to EOCs without MetS. Inflammation was associated with MetS and LTF with causal relation. Inflammation could play a role in persistent fatigue and interventions to reduce MetS may help to improve LTF.

Disclosures

None