J Korean Med Sci.  2014 Jun;29(6):793-797. 10.3346/jkms.2014.29.6.793.

The Effect of Body Mass Index on Survival in Advanced Epithelial Ovarian Cancer

• Bae HS
• Hong JH
• Ki KD
• Song JY
• Shin JW
• Lee JM
• Lee JK
• Lee NW
• Lee C
• Lee KW
• Kim YM

• KMID: 1796941
• DOI: http://doi.org/10.3346/jkms.2014.29.6.793

Abstract

Controversy remains regarding the effect of obesity on the survival of patients with ovarian cancer in Asia. This study examined the impact of obesity on the survival outcomes in advanced epithelial ovarian cancer (EOC) using Asian body mass index (BMI) criteria. The medical records of patients undergoing surgery for advanced (stage III and IV) EOC were reviewed. Statistical analyses included ANOVA, chi-square test, Kaplan-Meier survival and Cox regression analysis. Among all 236 patients, there were no differences in overall survival according to BMI except in underweight patients. In a multivariate Cox analysis, surgical optimality and underweight status were independent and significant prognostic factors for survival (HR, 2.302; 95% CI, 1.326-3.995; P=0.003 and HR, 8.622; 95% CI, 1.871-39.737; P = 0.006, respectively). In the subgroup of serous histology and optimal surgery, overweight and obese I patients showed better survival than normal weight patients (P = 0.012). We found that underweight BMI and surgical optimality are independent risk factors for the survival of patients with advanced ovarian cancer. High BMI groups (overweight, obese I and II) are not associated with the survival of advanced EOC patient. However, in the subgroup of EOC patients with serous histology and after optimal operation, overweight and obese I group patients show better survival than the normal weight group patients.

Keyword

Ovarian Neoplasms; Survival; Body Mass Index; Obesity

MeSH Terms

Adolescent
Adult
Aged
*Body Mass Index
Female
Humans
Kaplan-Meier Estimate
Middle Aged
Neoplasm Staging
Neoplasms, Glandular and Epithelial/*diagnosis/mortality/pathology
Ovarian Neoplasms/*diagnosis/mortality/pathology
Proportional Hazards Models
Retrospective Studies
Risk Factors
Young Adult

Figure

• 

  Fig. 1 Survival of patients with serous ovarian cancer after optimal surgery (n = 97). (A) Underweight patients have significantly poorer survival than other BMI groups (P = 0.031) and obese II patients showed no significant difference in survival compared to normal weight, overweight and obese I patients (P = 0.097). (B) However, among three mid-range BMI groups, overweight and obese I patients have a higher rate of survival than normal weight patients (P = 0.012).

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