The effect of obesity on survival in patients with ovarian cancer

Abstract

Objective Data has suggested obesity as an independent prognostic factor for lower survival in patients with epithelial ovarian cancer (EOC). We sought to determine if obesity portends a disadvantage to surgical outcomes at the time of initial surgery affecting survival. Methods A retrospective chart review of patients diagnosed with EOC was performed. All patients underwent primary cytoreductive surgery followed by taxane/platinum-based chemotherapy. Patient demographics, surgicopathologic and survival data were evaluated. Patients were compared based on body mass index (BMI) (< 30 vs. ≥ 30) and BMI strata (underweight, normal weight, overweight, obese and morbidly obese). Survival analyses were performed with the Kaplan Meier method and compared using the log rank test, χ 2 test, and Fischer's exact test. Results 304 patients were identified. 71 patients (23%) were obese (BMI > 30). The groups were similar in regard to stage, grade, histology, and chemotherapy administered. In regard to surgical outcomes, no difference was seen in estimated blood loss (EBL), operating room (OR) time, or operative complications excluding wound complications. Optimal debulking rates were similar in obese and non-obese patients (52% vs. 51% respectively, p = 0.88). There was no statistical difference in progression free survival (17 vs. 11 months) or overall survival (48 vs. 40 months) between the two groups or across BMI strata. Conclusion Although obesity has been reported as an independent prognostic factor for survival, this data demonstrates that survival rates are similar between obese and non-obese patients when optimal debulking statuses are the same. Therefore, maximal effort should be directed towards optimal debulking obese patients with EOC.