Impact of obesity on survival outcomes of women with advanced epithelial ovarian cancer in Lagos, Nigeria: a retrospective cohort study.

Abstract

Epithelial ovarian cancer (EOC) is a major contributor to cancer-related illness and death among women worldwide. Obesity, a prevalent condition in many populations, has been implicated as a risk factor for various malignancies including EOC. This study investigated the impact of obesity on survival outcomes among women with advanced EOC in Lagos, Nigeria. We conducted a retrospective analysis of patient medical records from a major gynaecological cancer unit of a teaching hospital in Lagos, Southwest Nigeria, to examine the relationship between body mass index (BMI) 30 kg/m2 as a measure of obesity, and progression-free (PFS) and overall survival (OS). We used Kaplan-Meier analysis stratified by patients' BMI categories (obese versus non-obese) and compared using the Log Rank test to estimate PFS and OS. The multivariable Cox proportional hazard model was used to estimate hazard ratios (HR) of the associations between the BMI categories and survival outcomes while adjusting for all confounding clinicopathologic variables. Hypothesis tests were conducted using a two-tailed approach with a significance level of 5%. Our study showed no statistically significant association between obesity and PFS (adjusted HR = 0.62, 95% confidence interval = 0.36-1.06, p = 0.282). However, a significant association was observed between obesity with or without ascites and OS (adjusted HR = 3.58, 95% confidence interval 1.28-10.02, p = 0.015). Our findings suggest that obesity negatively impacts OS in patients with EOC, thus highlighting the need to address obesity in the management of EOC by introducing comprehensive, multidisciplinary approaches incorporating weight management and personalized treatment strategies to enhance the prognosis of these patients.