Muju Health Center and County Hospital, Muju, Republic of Korea.
Int J Gynecol Cancer. 2011 Dec;21(9):1525-32. doi: 10.1097/IGC.0b013e31822eb5f8.
Although obesity is shown to be a risk factor for epithelial ovarian cancer, its role as a prognostic factor has been remained inconclusive. In this study, available evidences on this matter to date have been assembled for a meta-analysis to determine the effect of obesity on the survival of patients with epithelial ovarian cancer.
Eligible studies published up to December 2010 were searched using MEDLINE (PubMed), EMBASE, and Cochrane Central Register of Controlled Trials, and manual review of relevant bibliography to look for additional studies was done. Adjusted hazard ratios (HRs) from individual studies were pooled using a random-effects model.
Ten cohort studies of 331 screened articles were included in the final analysis. The meta-analysis showed overweight or obesity at early adulthood to be associated with higher mortality among patients with ovarian cancer (HR, 1.60; 95% confidence interval, 1.10-2.34). Among patients with advanced ovarian cancer, premorbid obesity was associated with worse prognosis (HR, 1.45; 95% confidence interval, 1.09-1.93). However, there was no significant relationship between prognosis and obesity around the time of diagnosis.
This study suggests a possible relationship between obesity at early adulthood and higher mortality among patients with ovarian cancer. Further studies are needed to elucidate the harmful effect of obesity on the survival of patients with ovarian cancer.
尽管肥胖已被证实是上皮性卵巢癌的一个危险因素,但它作为预后因素的作用仍不确定。本研究对迄今为止这方面的现有证据进行了荟萃分析,以确定肥胖对上皮性卵巢癌患者生存的影响。
检索 MEDLINE(PubMed)、EMBASE 和 Cochrane 对照试验中心注册数据库,查找截至 2010 年 12 月发表的相关研究,同时对参考文献进行手工检索以寻找其他研究。使用随机效应模型对个体研究的调整后的危险比(HR)进行汇总。
对 331 篇筛选文章中的 10 项队列研究进行了最终分析。荟萃分析显示,青年期超重或肥胖与卵巢癌患者死亡率升高相关(HR,1.60;95%置信区间,1.10-2.34)。对于晚期卵巢癌患者,发病前肥胖与预后较差相关(HR,1.45;95%置信区间,1.09-1.93)。然而,肥胖与诊断时的预后之间无显著关系。
本研究提示青年期肥胖可能与卵巢癌患者死亡率升高相关。需要进一步研究阐明肥胖对卵巢癌患者生存的有害影响。