Weighing your risks: Obesity and ovarian cancer.
Hijaz M, Rasool N, Munkarah AR, and Rattan R. Weighing your risks: Obesity and ovarian cancer. Gynecol Oncol 2017; 145:202.
Objective: Observational studies have demonstrated an association between higher BMI and an increased risk of ovarian cancer. The aim of our study is to analyze the potential association between obesity, tumor characteristics, and patient outcome. Method: We performed a retrospective chart review of 369 patients diagnosed with ovarian, fallopian tube, and primary peritoneal cancer at our hospital from 1991 to 2014. Patient characteristics included age at diagnosis, BMI, stage, grade, histopathology, debulking status (optimal vs suboptimal), and overall comorbidity score. Measured outcomes included neoadjuvant chemotherapy rate, postoperative complications, progression-free survival, overall survival, cancerspecific deaths, and recurrence rate. Statistical analyses included ANOVA, ?2 test, Kaplan-Meier survival, and Cox regression analysis. Results: Among all the patients studied, 30.43% had a BMI b25 kg/m2, 33.05% were between 25 and 29.9 kg/m2, and 36.52 were above 30 kg/m2. Analysis of tumor histopathologies across the BMI strata showed a significant association between mucinous histology and a BMI N30 (18.4% vs 2.8%, P b 0.003). The proportion of patients with BMI N30 who underwent primary surgery and achieved optimal debulking was not different from those with BMI b30 (P = 0.092), with no significant difference in postoperative complication rate (P= 0.07). Survival analyses in the 3 BMI subgroups did not show a significant difference with regard to progression-free survival, overall survival, or recurrence rate. Conclusion: Overweight, obese, and morbidly obese ovarian cancer patients had survival similar to that of normal weight patients. Interestingly, we found a significant association between morbid obesity and mucinous histology, a finding that warrants further investigation.