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Meta-Analysis
. 2014 Apr 22:7:41.
doi: 10.1186/1757-2215-7-41. eCollection 2014.

Obesity and epithelial ovarian cancer survival: a systematic review and meta-analysis

Hyo Sook Bae  1 , Hyun Jung Kim  2 , Jin Hwa Hong  1 , Jae Kwan Lee  1 , Nak Woo Lee  1 , Jae Yun Song  1
Affiliations
Meta-Analysis

Obesity and epithelial ovarian cancer survival: a systematic review and meta-analysis

Hyo Sook Bae et al. J Ovarian Res. .

Abstract

Background: Studies on the association between obesity and ovarian cancer survival have had conflicting results. We reviewed and quantitatively summarized the existing evidence, exploring potentially important sources of variability, such as the timing of body mass index (BMI) assessment, BMI cut points, references used in multivariate analysis, and ovarian cancer stage.

Methods: Eligible studies were searched using MEDLINE (PubMed), EMBASE, and Cochrane Central Register of Controlled Trials, relevant bibliographies were manually reviewed for additional studies. Adjusted hazard ratios (HRs) from individual studies were pooled using a random effects model.

Results: 17 cohort studies of 929 screened articles were included in the final analysis. Obesity in early adulthood and obesity 5 years before ovarian cancer diagnosis were associated with poor patient survival (early adulthood: pooled HR 1.67; 95% CI 1.29-2.16; 5 years prediagnosis: pooled HR 1.35; 95% CI 1.03-1.76). However, the results for obesity at diagnosis depended on whether BMI was analyzed as a categorical or continuous variable. Analysis of obesity with BMI as a categorical variable did not affect ovarian cancer prognosis (pooled HR 1.07; 95% CI 0.95-1.21); obesity with BMI as a continuous variable showed slightly poorer survival with each incremental increase in BMI (pooled HR 1.02; 95% CI 1.01-1.04).

Conclusions: Obesity 5 years before ovarian cancer diagnosis and obesity at a young age were associated with poor prognosis. The association between obesity at diagnosis and survival of ovarian cancer patients still remains equivocal. BMI at diagnosis cannot be a prognostic factor for the survival of ovarian cancer patients. Further well-designed studies are needed to elucidate the variety effect of obesity on the survival of ovarian cancer patients.

Keywords: Body mass index; Obesity; Ovarian Neoplasms; Survival.

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Figures

Figure 1
Figure 1
Flow diagram.
Figure 2
Figure 2
Obesity before diagnosis. (Note: BMI ≥ 25–30).
Figure 3
Figure 3
Obesity at diagnosis (normal weight as reference).
Figure 4
Figure 4
Obesity at diagnosis (low-weight as reference).
Figure 5
Figure 5
BMI as continuous variable.
See this image and copyright information in PMC

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