title: The effect of body mass index on survival in advanced epithelial ovarian cancer.
abstract: Controversy remains regarding the effect of obesity on the survival of patients with ovarian cancer in Asia. This study examined the impact of obesity on the survival outcomes in advanced epithelial ovarian cancer (EOC) using Asian body mass index (BMI) criteria. The medical records of patients undergoing surgery for advanced (stage III and IV) EOC were reviewed. Statistical analyses included ANOVA, chi-square test, Kaplan-Meier survival and Cox regression analysis. Among all 236 patients, there were no differences in overall survival according to BMI except in underweight patients. In a multivariate Cox analysis, surgical optimality and underweight status were independent and significant prognostic factors for survival (HR, 2.302; 95% CI, 1.326-3.995; P=0.003 and HR, 8.622; 95% CI, 1.871-39.737; P = 0.006, respectively). In the subgroup of serous histology and optimal surgery, overweight and obese I patients showed better survival than normal weight patients (P = 0.012). We found that underweight BMI and surgical optimality are independent risk factors for the survival of patients with advanced ovarian cancer. High BMI groups (overweight, obese I and II) are not associated with the survival of advanced EOC patient. However, in the subgroup of EOC patients with serous histology and after optimal operation, overweight and obese I group patients show better survival than the normal weight group patients.
authors.affiliation: Department of Obstetrics and Gynecology, Korea University College of Medicine, Seoul, Korea.
authors.forename: Hyo Sook
authors.identifier: 0000-0001-8829-6480
authors.initials: HS
authors.lastname: Bae
authors.affiliation: Department of Obstetrics and Gynecology, Korea University College of Medicine, Seoul, Korea.
authors.forename: Jin Hwa
authors.identifier: 0000-0002-6905-5363
authors.initials: JH
authors.lastname: Hong
authors.affiliation: Department of Obstetrics and Gynecology, Kyung Hee University Hospital at Gangdong, Seoul, Korea.
authors.forename: Kyoung-Do
authors.identifier: 0000-0002-1060-2297
authors.initials: KD
authors.lastname: Ki
authors.affiliation: Department of Obstetrics and Gynecology, Korea University College of Medicine, Seoul, Korea.
authors.forename: Jae Yun
authors.identifier: 0000-0002-2752-5638
authors.initials: JY
authors.lastname: Song
authors.affiliation: Department of Obstetrics and Gynecology, Gachon University Gil Medical Center, Incheon, Korea.
authors.forename: Jin Woo
authors.identifier: 0000-0002-1967-8124
authors.initials: JW
authors.lastname: Shin
authors.affiliation: Department of Obstetrics and Gynecology, Kyung Hee University Hospital at Gangdong, Seoul, Korea.
authors.forename: Jong Min
authors.identifier: 0000-0002-0562-5443
authors.initials: JM
authors.lastname: Lee
authors.affiliation: Department of Obstetrics and Gynecology, Korea University College of Medicine, Seoul, Korea.
authors.forename: Jae Kwan
authors.identifier: 0000-0002-9727-3587
authors.initials: JK
authors.lastname: Lee
authors.affiliation: Department of Obstetrics and Gynecology, Korea University College of Medicine, Seoul, Korea.
authors.forename: Nak Woo
authors.identifier: 0000-0001-9405-7574
authors.initials: NW
authors.lastname: Lee
authors.affiliation: Department of Gynecologic Oncology, College of Medicine, CHA University, Seongnam, Korea.
authors.forename: Chan
authors.identifier: 0000-0003-1654-4398
authors.initials: C
authors.lastname: Lee
authors.affiliation: Department of Obstetrics and Gynecology, Korea University College of Medicine, Seoul, Korea.
authors.forename: Kyu Wan
authors.identifier: 0000-0003-2692-3527
authors.initials: KW
authors.lastname: Lee
authors.affiliation: Department of Gynecologic Oncology, College of Medicine, CHA University, Seongnam, Korea.
authors.forename: Yong Min
authors.initials: YM
authors.lastname: Kim
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015992:Body Mass Index; D000077216:Carcinoma, Ovarian Epithelial; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008875:Middle Aged; D009367:Neoplasm Staging; D009375:Neoplasms, Glandular and Epithelial / Q000175:diagnosis* / Q000401:mortality / Q000473:pathology; D010051:Ovarian Neoplasms / Q000175:diagnosis* / Q000401:mortality / Q000473:pathology; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D055815:Young Adult
keywords: Body Mass Index; Obesity; Ovarian Neoplasms; Survival