Recreational physical inactivity and mortality in women with invasive epithelial ovarian cancer: evidence from the Ovarian Cancer Association Consortium

Abstract

Background:Little is known about modifiable behaviours that may be associated with epithelial ovarian cancer (EOC) survival. We conducted a pooled analysis of 12 studies from the Ovarian Cancer Association Consortium to investigate the association between pre-diagnostic physical inactivity and mortality.Methods:Participants included 6806 women with a primary diagnosis of invasive EOC. In accordance with the Physical Activity Guidelines for Americans, women reporting no regular, weekly recreational physical activity were classified as inactive. We utilised Cox proportional hazard models to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) representing the associations of inactivity with mortality censored at 5 years.Results:In multivariate analysis, inactive women had significantly higher mortality risks, with (HR=1.34, 95% CI: 1.18–1.52) and without (HR=1.22, 95% CI: 1.12–1.33) further adjustment for residual disease, respectively.Conclusion:In this large pooled analysis, lack of recreational physical activity was associated with increased mortality among women with invasive EOC.

History of hypertension, heart disease, and diabetes and ovarian cancer patient survival: evidence from the ovarian cancer association consortium

“…Another limitation is that we were not able to restrict our analyses to cases who died of ovarian cancer since, in our study population, the information on cause of death was available for a limited number of patients. However, among cases with a known cause of death, 94.5% of patients died from ovarian cancer, which is very similar to the percentage of cases who died of this disease reported in other OCAC survival studies [66, 67]. Therefore, we could assume that, for OS, our results approximate ovarian cancer survival fairly well.…”

Epidemiology of epithelial ovarian cancer

“…Obese women may have poorer survival than their normal weight counterparts, perhaps, in part, due to the practice of dose-capping whereby obese women are not given the full chemotherapy dose for their body-size because of toxicity concerns [92]. A recent pooled analysis suggested women who were sedentary prior to diagnosis had worse outcomes [93] and others have reported benefits for those with a more healthy diet [94].However, these and most other studies are based on what women did prior to their diagnosis.Aside from the likely benefits of physical activity based on evidence from other cancer types [95], there is currently a lack of evidence to inform lifestyle advice for women after they are diagnosed with ovarian cancer.[3869 words] M A N U S C R I P T …”

“…Obese women may have poorer survival than their normal weight counterparts, perhaps, in part, due to the practice of dose-capping whereby obese women are not given the full chemotherapy dose for their body-size because of toxicity concerns [92]. A recent pooled analysis suggested women who were sedentary prior to diagnosis had worse outcomes [93] and others have reported benefits for those with a more healthy diet [94].…”

A Physiological Profile of Ovarian Cancer Survivors to Inform Tailored Exercise Interventions and the Development of Exercise Oncology Guidelines

“…10,11 The association between physical activity after an OC diagnosis and mortality remains unclear, although prediagnostic physical activity appears to affect survival in this cancer group. 83 Ovarian cancer survivors who report being more physically active have reduced symptom burden, improved physical fitness and function, and a better quality of life. 34,36,67,68,84 However, most studies investigating physical activity in OC survivors are cross-sectional in design, which precludes inferring conclusions about causality and indicates a need for future prospective randomized controlled trials.…”