TY - JOUR

T1 - Obesity and survival among women with ovarian cancer

T2 - results from the Ovarian Cancer Association Consortium

AU - Nagle, C M

AU - Dixon, S C

AU - Jensen, A.

AU - Kjaer, S K

AU - Modugno, F

AU - deFazio, A

AU - Fereday, S

AU - Hung, J

AU - Johnatty, S E

AU - Fasching, P A

AU - Beckmann, M W

AU - Lambrechts, D

AU - Vergote, I

AU - Van Nieuwenhuysen, E

AU - Lambrechts, S

AU - Risch, H A

AU - Rossing, M A

AU - Doherty, J A

AU - Wicklund, K G

AU - Chang-Claude, J

AU - Goodman, M T

AU - Ness, R B

AU - Moysich, K

AU - Heitz, F

AU - du Bois, A

AU - Harter, P

AU - Schwaab, I

AU - Matsuo, K

AU - Hosono, S

AU - Goode, E L

AU - Vierkant, R A

AU - Larson, M C

AU - Fridley, B L

AU - Høgdall, C

AU - Schildkraut, J M

AU - Weber, R P

AU - Cramer, D W

AU - Terry, K L

AU - Bandera, E V

AU - Paddock, L

AU - Rodriguez-Rodriguez, L

AU - Wentzensen, N

AU - Yang, H P

AU - Brinton, L A

AU - Lissowska, J

AU - Høgdall, E

AU - Lundvall, L

AU - Whittemore, A

AU - McGuire, V

AU - Sieh, W

AU - Australian Ovarian Cancer Study Group

PY - 2015/9/1

Y1 - 2015/9/1

N2 - BACKGROUND: 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.METHODS: 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.RESULTS: 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.CONCLUSIONS: Higher BMI is associated with adverse survival among the majority of women with ovarian cancer.

AB - BACKGROUND: 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.METHODS: 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.RESULTS: 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.CONCLUSIONS: Higher BMI is associated with adverse survival among the majority of women with ovarian cancer.

KW - Body Mass Index

KW - Disease-Free Survival

KW - Female

KW - Humans

KW - Kaplan-Meier Estimate

KW - Neoplasms, Glandular and Epithelial

KW - Obesity

KW - Ovarian Neoplasms

U2 - 10.1038/bjc.2015.245

DO - 10.1038/bjc.2015.245

M3 - Journal article

C2 - 26151456

VL - 113

SP - 817

EP - 826

JO - The British journal of cancer. Supplement

JF - The British journal of cancer. Supplement

SN - 0007-0920

IS - 5

ER -