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

Abstract

Studies that have examined the association between obesity and ovarian cancer survival have provided conflicting results. We reviewed and quantitatively summarized existing evidence, exploring potentially important sources of variability, such as the timing of body mass index (BMI) assessment and different cutpoints used to categorize BMI. A systematic search of MEDLINE and EMBASE was conducted to identify original data evaluating the association between obesity and survival in women with ovarian cancer. Adjusted hazard ratios (HR) from studies were pooled using a random-effects model. The meta-analysis of 14 studies showed slightly poorer survival among obese than in non-obese women [pooled HR, 1.17; 95% confidence interval (CI), 1.03-1.34]. This estimate did not vary appreciably when BMI was measured before diagnosis (1.13; 0.95-1.35), at the time of diagnosis (1.13; 0.81-1.57) or at the commencement of chemotherapy (1.12; 0.96-1.31). We found a slightly stronger association in studies that only included women with a BMI 30 in their "obese" group (1.20) than in studies that also included overweight women (BMI 25; 1.14). Women with ovarian cancer who are obese appear to have slightly worse survival than non-obese women. However, there is a large amount of inter-study variation, which means that no solid conclusions can be drawn. Cancer Prev Res; 5(7); 901-10. Ó2012 AACR.

European Code against Cancer 4th Edition: Obesity, body fatness and cancer

“…Mortality after ovarian cancer is 17% (95%CI: 3-34%) higher among obese compared to non-obese women [59]. Although the number of studies is still small, there is emerging evidence that higher BMI is associated with poorer cancer-specific mortality from endometrial cancer [60].…”

Asociación entre obesidad y cáncer de ovario

“…Si bien dicha terapia ha sido asociada generalmente como un factor de riesgo del cáncer de ovario 19 , un meta-análisis establece que no observaron diferencias entre IMC y cáncer de ovario entre mujeres post-menopáusicas que utilizaron terapia de reemplazo hormonal y las que no. Este estudio, además, establece que la obesidad aumenta el riesgo de desarrollar los cáncer de ovario histológicamente menos frecuentes (serosos que presentan un alto grado de agresividad y los borderline) y, finalmente, los autores concluyen que un bajo IMC no previene la letalidad del cáncer de ovario, por lo tanto, no actuaría como un factor protector 15 .…”

“…En concordancia con esto, un estudio poblacional muestra que las mujeres obesas que no utilizan terapia de reemplazo hormonal tienen un riesgo mayor (80%) de desarrollar cáncer de ovario respecto a las mujeres de peso normal 13 . Finalmente, lo anterior se relaciona con un meta-análisis reciente donde se encuentra que las personas no obesas tendrían una mejor sobrevida al cáncer de ovario versus las obesas y que esta asociación podría relacionarse con las características histológicas del cáncer 14,15 .…”

The Association Between Body Mass Index and Presenting Symptoms in African American Women with Ovarian Cancer

“…African American women are nearly twice as likely to be obese as non-Hispanic white women (59% vs. 32%), 3 and a growing body of evidence suggests that obesity is associated with both ovarian cancer risk and survival. [4][5][6] Meta-analyses and pooled analyses conducted among predominantly white populations have concluded that overweight and obese women are at increased risk for ovarian cancer 4,5 and have poorer survival after an ovarian cancer diagnosis. 6 For African American women, some 7,8 but not all 9 studies suggest obesity is a risk factor for ovarian cancer.…”

“…[4][5][6] Meta-analyses and pooled analyses conducted among predominantly white populations have concluded that overweight and obese women are at increased risk for ovarian cancer 4,5 and have poorer survival after an ovarian cancer diagnosis. 6 For African American women, some 7,8 but not all 9 studies suggest obesity is a risk factor for ovarian cancer. No studies have specifically addressed the effect of obesity on ovarian cancer survival among African American women.…”