Dietary influences on survival after ovarian cancer

Abstract

We evaluated the effects of various food groups and micronutrients in the diet on survival among women who originally participated in a population-based case-control study of ovarian cancer conducted across 3 Australian states between 1990 and 1993. This analysis included 609 women with invasive epithelial ovarian cancer, primarily because there was negligible mortality in women with borderline tumors. The women's usual diet was assessed using a validated food frequency questionnaire. Deaths in the cohort were identified using state-based cancer registries and the Australian National Death Index (NDI). Crude 5-year survival probabilities were estimated using the Kaplan-Meier technique, and adjusted hazard ratios (HRs) and 95% confidence intervals ( Key words: ovarian cancer; diet; survivalOvarian cancer is a major cause of cancer mortality in women, primarily due to the insidious onset and consequential late diagnosis of the disease in many women. Given the high proportion of late-stage disease at diagnosis, treatment outcomes are often poor, even in specialized gynecologic oncology centers. 1 For the time being, advancing diagnosis through screening is infeasible as a serious public health option. 2 Similarly, practical strategies for primary prevention remain limited. Efforts to identify other preventive factors or modifiable causes, dietary 3,4 and otherwise, 5 are under way, but as yet have not yielded definitive results.We thus considered it worthwhile to examine whether any lifestyle factors over which women might exert some control could improve their prognosis. We have followed up on women who were enrolled in an etiologic study of ovarian cancer in the early 1990s 6 and report here our initial findings regarding possible influences of diet on survival. We are unaware of any previous report of this, or any other nonclinical prognostic factor, for ovarian cancer. MATERIAL AND METHODSOur study assesses the mortality experience of a large group of Australian women diagnosed with epithelial ovarian cancer in the early 1990s, enrolled in a case-control study, 6 and in particular explores the possible influence of various dietary factors on survival. Ethics approval for the research was received from the University of Queensland and all metropolitan hospitals where patients were recruited. All participants gave informed consent prior to enrollment, including granting the study investigators full access to their medical records.The study population comprised 822 women with incident epithelial ovarian cancer (90% of all eligible cases ascertained) who were diagnosed between 1990 and 1993, aged 18 -79 years and identified through major gynecology-oncology centres in the Australian states of Queensland, New South Wales and Victoria. Comparisons with registry data indicated that close to 100% of all Queensland cases, and about half of those diagnosed in the other states, were enrolled. Of a total of 1,116 cases of epithelial ovarian cancer identified, 184 were ineligible, and 19 were unable to complete the questio...

Cigarette Smoking and Survival after Ovarian Cancer Diagnosis

“…Histologic diagnoses were reviewed centrally by a single pathologist in each state as part of the original case-control study. Full details have been presented elsewhere (15). The cohort was followed for mortality until June 30, 1999.…”

“…The P for linear trend was calculated by the change in the likelihood ratio statistic for entry of a linear term for the continuous variable in the model and thus was a m 2 test on 1 degree of freedom. All analyses were adjusted for known prognostic factors, age at diagnosis, International Federation of Gynecology and Obstetrics (FIGO) stage, and grade (15), in addition to histologic subtype, amount of residual disease, treatment with platinum-based chemotherapy, and body mass index (BMI) to allow for direct comparison with the results of Kjaerbye-Thygesen et al (12). We also considered aspects of diet (vegetables and vitamin E intake, alcohol and caffeine consumption, and total kilocalories) and relevant etiologic factors (duration of oral contraceptive use, parity, history of tubal ligation, and hysterectomy) as potential confounders but did not include them in the final models as they did not alter the effect estimates.…”

Obesity and Ovarian Cancer Survival: A Systematic Review and Meta-analysis

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Kallikrein-Related Peptidase 3(KLK3/PSA) Single Nucleotide Polymorphisms and Ovarian Cancer Survival

“…Full details have been reported previously (Nagle et al, 2003). The women were followed for mortality using personal identifiers that were linked to the Australian National Death Index (NDI), state cancer registry records and the RBH Gynecology Oncology database (Nagle et al, 2006).…”