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Obesity and survival among women with ovarian cancer: results from the Ovarian Cancer Association Consortium.

ABSTRACT: Observational studies have reported a modest association between obesity and risk of ovarian cancer; however, whether it is also associated with survival and whether this association varies for the different histologic subtypes are not clear. We undertook an international collaborative analysis to assess the association between body mass index (BMI), assessed shortly before diagnosis, progression-free survival (PFS), ovarian cancer-specific survival and overall survival (OS) among women with invasive ovarian cancer.We used original data from 21 studies, which included 12?390 women with ovarian carcinoma. We combined study-specific adjusted hazard ratios (HRs) using random-effects models to estimate pooled HRs (pHR). We further explored associations by histologic subtype.Overall, 6715 (54%) deaths occurred during follow-up. A significant OS disadvantage was observed for women who were obese (BMI: 30-34.9, pHR: 1.10 (95% confidence intervals (CIs): 0.99-1.23); BMI: ?35, pHR: 1.12 (95% CI: 1.01-1.25)). Results were similar for PFS and ovarian cancer-specific survival. In analyses stratified by histologic subtype, associations were strongest for women with low-grade serous (pHR: 1.12 per 5?kg?m(-2)) and endometrioid subtypes (pHR: 1.08 per 5?kg?m(-2)), and more modest for the high-grade serous (pHR: 1.04 per 5?kg?m(-2)) subtype, but only the association with high-grade serous cancers was significant.Higher BMI is associated with adverse survival among the majority of women with ovarian cancer.

SUBMITTER: Nagle CM

PROVIDER: S-EPMC4559823 | biostudies-other | 2015 Sep

REPOSITORIES: biostudies-other

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Obesity and survival among women with ovarian cancer: results from the Ovarian Cancer Association Consortium.

Nagle C M CM Dixon S C SC Jensen A A Kjaer S K SK Modugno F F deFazio A A Fereday S S Hung J J Johnatty S E SE Fasching P A PA Beckmann M W MW Lambrechts D D Vergote I I Van Nieuwenhuysen E E Lambrechts S S Risch H A HA Rossing M A MA Doherty J A JA Wicklund K G KG Chang-Claude J J Goodman M T MT Ness R B RB Moysich K K Heitz F F du Bois A A Harter P P Schwaab I I Matsuo K K Hosono S S Goode E L EL Vierkant R A RA Larson M C MC Fridley B L BL Høgdall C C Schildkraut J M JM Weber R P RP Cramer D W DW Terry K L KL Bandera E V EV Paddock L L Rodriguez-Rodriguez L L Wentzensen N N Yang H P HP Brinton L A LA Lissowska J J Høgdall E E Lundvall L L Whittemore A A McGuire V V Sieh W W Rothstein J J Sutphen R R Anton-Culver H H Ziogas A A Pearce C L CL Wu A H AH Webb P M PM

British journal of cancer 20150707 5

<h4>Background</h4>Observational studies have reported a modest association between obesity and risk of ovarian cancer; however, whether it is also associated with survival and whether this association varies for the different histologic subtypes are not clear. We undertook an international collaborative analysis to assess the association between body mass index (BMI), assessed shortly before diagnosis, progression-free survival (PFS), ovarian cancer-specific survival and overall survival (OS) a ...[more]

PMID: 26151456

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Project description:PURPOSE:Previous epidemiologic studies have shown that smoking, obesity, and physical inactivity are associated with poor survival following a diagnosis of ovarian cancer. Yet, the combined relationship of these unfavorable lifestyle factors on ovarian cancer survival has not been sufficiently investigated. METHODS:Using data pooled from 13 studies, we examined the associations between combined exposures to smoking, overweight/obesity weight, and physical inactivity and overall survival (OS) as well as progression-free survival (PFS) among women diagnosed with invasive epithelial ovarian carcinoma (n?=?7,022). Using age- and stage-adjusted Cox proportional hazards regression models, we estimated hazard ratios (HRs) and 95% confidence intervals (CIs) associated with joint exposure to these factors. RESULTS:Combined exposure to current smoking, overweight/obesity, and physical inactivity prior to diagnosis was associated with a significantly increased risk of mortality compared to women who never smoked, had normal body mass index (BMI), and were physically active (HR?=?1.37; 95% CI 1.10-1.70). The association for a joint exposure to these factors exceeded that of each exposure individually. In fact, exposure to both current smoking and overweight/obesity, and current smoking and physical inactivity was also associated with increased risk of death (HR?=?1.28; 95% CI 1.08-1.52, and HR?=?1.26; 95% CI 1.04-1.54, respectively). The associations were of a similar magnitude when former smoking was assessed in combination with the other exposures and when excessive weight was limited to obesity only. No significant associations were observed between joint exposure to any of these factors and PFS. CONCLUSIONS:Joint exposure to smoking, excessive weight, and physical inactivity may negatively impact survival of ovarian cancer patients. These results suggest the importance of examining the combined effect of lifestyle factors on ovarian cancer patients' survival.

Dataset Information

Obesity and survival among women with ovarian cancer: results from the Ovarian Cancer Association Consortium.

Publications

Obesity and survival among women with ovarian cancer: results from the Ovarian Cancer Association Consortium.

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