Article open access publication

Obesity and survival among women with ovarian cancer: results from the Ovarian Cancer Association Consortium

British Journal of Cancer, Springer Nature, ISSN 0007-0920

Volume 113, 5, 2015

DOI:10.1038/bjc.2015.245, Dimensions: pub.1029976512, PMC: PMC4559823, PMID: 26151456,



  1. (1) QIMR Berghofer Medical Research Institute, grid.1049.c
  2. (2) University of Queensland, grid.1003.2
  3. (3) Danish Cancer Society, grid.417390.8
  4. (4) Department of Gynecology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
  5. (5) University of Pittsburgh, grid.21925.3d
  6. (6) University of Pittsburgh Cancer Institute, grid.478063.e
  7. (7) Westmead Hospital, grid.413252.3
  8. (8) Westmead Institute for Medical Research, grid.452919.2
  9. (9) Peter MacCallum Cancer Centre, grid.1055.1
  10. (10) University of California, Los Angeles, grid.19006.3e
  11. (11) Department of Gynecology and Obstetrics, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Comprehensive Cancer Center Erlangen-EMN, Erlangen, Germany
  12. (12) Flanders Institute for Biotechnology, grid.11486.3a
  13. (13) KU Leuven, grid.5596.f
  14. (14) Universitair Ziekenhuis Leuven, grid.410569.f
  15. (15) Yale University, grid.47100.32
  16. (16) Fred Hutchinson Cancer Research Center, grid.270240.3
  17. (17) Dartmouth College, grid.254880.3
  18. (18) German Cancer Research Center, grid.7497.d
  19. (19) Cedars-Sinai Medical Center, grid.50956.3f
  20. (20) The University of Texas Health Science Center at Houston, grid.267308.8
  21. (21) Roswell Park Cancer Institute, grid.240614.5
  22. (22) Department of Gynecology and Gynecologic Oncology, Dr Horst Schmidt Kliniken Wiesbaden, Wiesbaden, Germany
  23. (23) Department of Gynecology and Gynecologic Oncology, Kliniken Essen-Mitte/Evang. Huyssens Stiftung/Knappschaft GmbH, Essen, Germany
  24. (24) Institut für Humangenetik Wiesbaden, Wiesbaden, Germany
  25. (25) Kyushu University, grid.177174.3
  26. (26) Aichi Cancer Center, grid.410800.d
  27. (27) Mayo Clinic, grid.66875.3a
  28. (28) University of Kansas, grid.266515.3
  29. (29) Duke University Hospital, grid.189509.c
  30. (30) Brigham and Women's Hospital, grid.62560.37
  31. (31) Rutgers, The State University of New Jersey, grid.430387.b
  32. (32) New Jersey State Cancer Registry, Trenton, NJ, USA
  33. (33) National Institutes of Health, grid.94365.3d
  34. (34) Department of Cancer Epidemiology and Prevention, M. Sklodowska-Curie Cancer Center, Warsaw, Poland
  35. (35) University of Copenhagen, grid.5254.6, KU
  36. (36) Stanford University, grid.168010.e
  37. (37) University of South Florida, grid.170693.a
  38. (38) University of California, Irvine, grid.266093.8
  39. (39) University of Southern California, grid.42505.36


BACKGROUND: Observational studies have reported a modest association between obesity and risk of ovarian cancer; however, whether it is also associated with survival and whether this association varies for the different histologic subtypes are not clear. We undertook an international collaborative analysis to assess the association between body mass index (BMI), assessed shortly before diagnosis, progression-free survival (PFS), ovarian cancer-specific survival and overall survival (OS) among women with invasive ovarian cancer. METHODS: We used original data from 21 studies, which included 12 390 women with ovarian carcinoma. We combined study-specific adjusted hazard ratios (HRs) using random-effects models to estimate pooled HRs (pHR). We further explored associations by histologic subtype. RESULTS: Overall, 6715 (54%) deaths occurred during follow-up. A significant OS disadvantage was observed for women who were obese (BMI: 30-34.9, pHR: 1.10 (95% confidence intervals (CIs): 0.99-1.23); BMI: ⩾35, pHR: 1.12 (95% CI: 1.01-1.25)). Results were similar for PFS and ovarian cancer-specific survival. In analyses stratified by histologic subtype, associations were strongest for women with low-grade serous (pHR: 1.12 per 5 kg m(-2)) and endometrioid subtypes (pHR: 1.08 per 5 kg m(-2)), and more modest for the high-grade serous (pHR: 1.04 per 5 kg m(-2)) subtype, but only the association with high-grade serous cancers was significant. CONCLUSIONS: Higher BMI is associated with adverse survival among the majority of women with ovarian cancer.


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