Body mass index as a prognostic factor in epithelial ovarian cancer and correlation with clinico-pathological factors.

Objective: To find out if body mass index (BMI) was associated with clinico-pathological features and prognosis in epithelial ovarian cancer (EOC).

Design: Retrospective cohort study.

Setting: Patients with EOC, who underwent primary surgery and postoperative chemotherapy in the Orebro Medical Region, Sweden, 1994-2003.

Sample: A total of 446 patients with stage I-IV EOC, who underwent primary surgery and chemotherapy with information of values of height and weight at the start of chemotherapy were eligible.

Methods: Patients were stratified by BMI according to guidelines set forth by the World Health Organization. Pearson's chi-squared test was used for univariate analyses. The level of statistical significance was p < 0.05.

Main Outcome Measures: The survival curves were generated by using the Kaplan-Meier method, and in multivariate analyses the Cox regression model was used with cancer-specific survival as the end point. RESULTS. Of the patients, 5% were underweight (BMI < 18.5), 55% were of ideal body weight (BMI 18.5-25), 25% were overweight (BMI 25-30) and 15% were obese (BMI > 30). Among patients with serous tumors a significant (p = 0.01) worse survival was found in the subgroup of underweight (BMI < 18.5) patients compared with patients in the other BMI groups. In multivariate analysis only FIGO-stage and age were independent and significant prognostic factors.

Conclusion: Overweight and obese patients did not have worse survival than normal weight and underweight patients. The prognostic impact of BMI on survival was only noted for underweight patients with serous tumors.