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Br J Cancer. 2015 Sep 1;113(5):817-26. doi: 10.1038/bjc.2015.245. Epub 2015 Jul 7.

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

Author information

1
Population Health Department, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia.
2
School of Population Health, University of Queensland, Brisbane, QLD, Australia.
3
Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark.
4
Department of Gynecology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
5
Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, Pennsylvania, PA, USA.
6
Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pennsylvania, PA, USA.
7
Womens Cancer Research Program, Magee-Womens Research Institute and University of Pittsburgh Cancer Institute, Pennsylvania, PA, USA.
8
Department of Gynaecological Oncology, Westmead Hospital, Westmead, NSW, Australia.
9
Center for Cancer Research, University of Sydney at the Westmead Millennium Institute, Westmead, NSW, Australia.
10
Peter MacCallum Cancer Centre, East Melbourne, VIC, Australia.
11
Genetics and Computational Biology Department, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia.
12
David Geffen School of Medicine, Department of Medicine Division of Hematology and Oncology, University of California at Los Angeles, Los Angeles, CA, USA.
13
Department of Gynecology and Obstetrics, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Comprehensive Cancer Center Erlangen-EMN, Erlangen, Germany.
14
Vesalius Research Center, VIB, Leuven, Belgium.
15
Department of Oncology, University of Leuven, Leuven, Belgium.
16
Department of Obstetrics and Gynecology, Leuven Cancer Institute, University Hospitals Leuven, Leuven, Belgium.
17
Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT, USA.
18
Program in Epidemiology, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.
19
Department of Community and Family Medicine, The Geisel School of Medicine at Dartmouth, Lebanon, NH, USA.
20
Division of Cancer Epidemiology, German Cancer Research Center, Heidelberg, Germany.
21
Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
22
School of Public Health, University of Texas, Houston, TX, USA.
23
Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo, NY, USA.
24
Department of Gynecology and Gynecologic Oncology, Kliniken Essen-Mitte/Evang. Huyssens-Stiftung/Knappschaft GmbH, Essen, Germany.
25
Department of Gynecology and Gynecologic Oncology, Dr Horst Schmidt Kliniken Wiesbaden, Wiesbaden, Germany.
26
Institut für Humangenetik Wiesbaden, Wiesbaden, Germany.
27
Department of Preventive Medicine, Faculty of Medical Sciences, Kyushu University, Nagoya, Aichi, Japan.
28
Division of Epidemiology and Prevention, Aichi Cancer Center Research Institute, Nagoya, Aichi, Japan.
29
Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA.
30
Department of Biostatistics, University of Kansas, Kansas City, KS, USA.
31
Department of Community and Family Medicine, Duke University Medical Center, Durham, NC, USA.
32
Obstetrics and Gynecology Epidemiology Center, Brigham and Women's Hospital, Boston, MA, USA.
33
Rutgers Cancer Institute of New Jersey, Robert Wood Johnson Medical School, New Brunswick, NJ, USA.
34
New Jersey State Cancer Registry, Trenton, NJ, USA.
35
Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA.
36
Department of Cancer Epidemiology and Prevention, M. Sklodowska-Curie Cancer Center, Warsaw, Poland.
37
Molecular Unit, Department of Pathology, Herlev Hospital, University of Copenhagen, Copenhagen, Denmark.
38
Department of Health Research and Policy-Epidemiology, Stanford University School of Medicine, Stanford, CA, USA.
39
Epidemiology Center, College of Medicine, University of South Florida, Tampa, FL, USA.
40
Department of Epidemiology, School of Medicine, University of California Irvine, Irvine, California, USA.
41
Keck School of Medicine, University of Southern California Norris Comprehensive Cancer Center, Los Angeles, CA, USA.

Abstract

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.

PMID:
26151456
PMCID:
PMC4559823
DOI:
10.1038/bjc.2015.245
[Indexed for MEDLINE]
Free PMC Article

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