Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China.
Department of Epidemiology, School of Public Health, China Medical University, Shenyang, China.
J Transl Med. 2024 Sep 27;22(1):860. doi: 10.1186/s12967-024-05653-2.
There is currently a lack of comprehensive evidence regarding the correlation between Alternate Mediterranean Diet (AMED) and the survival of patients with ovarian cancer (OC). This prospective cohort study first assessed the association of AMED, not only pre-diagnosis and post-diagnosis but also the change from pre-diagnosis to post-diagnosis with OC survival.
A total of 560 OC patients were included in the study, and their dietary intake was assessed using a reliable 111-item food frequency questionnaire. The overall survival (OS) of the patients was monitored through active follow-up and review of medical records until February 16th, 2023. Cox proportional hazard regression models were utilized to compute the hazard ratios (HRs) and their corresponding 95% confidence intervals (CIs).
Out of the total 560 patients with OC, 211 (37.68%) succumbed during a median follow-up period of 44.40 months (interquartile range: 26.97-61.37). Comparative analysis indicated a significant association between the highest tertiles of pre-diagnosis (HR = 0.59; 95% CI 0.38-0.90; P < 0.05) and post-diagnosis (HR = 0.61; 95% CI 0.41-0.91; P < 0.05) AMED intake and improved OS as opposed to the lowest tertile. Additionally, a significant linear trend was observed for AMED and OC survival. Notably, decreased intake (more than 5% change) and significantly increased intake (more than 15% change) of AMED from pre-diagnosis to post-diagnosis were linked to worse and better OS, respectively, when compared to the stable intake group (change within 5%). Furthermore, patients displaying consistently higher AMED intake both before and after diagnosis experienced enhanced OS in comparison to those with consistently low AMED intake (HR = 0.47; 95% CI 0.31-0.70).
High pre-diagnosis and post-diagnosis AMED was associated with an improved OS in patients with OC, suggesting that maintaining a consistently high intake of AMED could potentially benefit the prognosis of OC.
目前，关于交替地中海饮食（AMED）与卵巢癌（OC）患者生存之间的相关性，尚无全面的证据。本前瞻性队列研究首次评估了 AMED 的相关性，不仅包括诊断前和诊断后，还包括从诊断前到诊断后的变化与 OC 生存的关系。
本研究共纳入 560 名 OC 患者，使用可靠的 111 项食物频率问卷评估其饮食摄入情况。通过主动随访和病历复查监测患者的总生存（OS）情况，直至 2023 年 2 月 16 日。使用 Cox 比例风险回归模型计算风险比（HR）及其 95%置信区间（CI）。
在 560 名 OC 患者中，211 名（37.68%）在中位随访 44.40 个月（四分位距：26.97-61.37）期间死亡。比较分析显示，诊断前（HR=0.59；95%CI 0.38-0.90；P<0.05）和诊断后（HR=0.61；95%CI 0.41-0.91；P<0.05）摄入 AMED 的最高三分位与改善 OS 之间存在显著关联，而最低三分位则无关联。此外，还观察到 AMED 与 OC 生存之间存在显著的线性趋势。值得注意的是，与稳定摄入组（变化在 5%以内）相比，从诊断前到诊断后 AMED 摄入减少（超过 5%的变化）和显著增加（超过 15%的变化）分别与较差和较好的 OS 相关。此外，与持续低 AMED 摄入相比，诊断前和诊断后均持续较高 AMED 摄入的患者 OS 改善（HR=0.47；95%CI 0.31-0.70）。
诊断前和诊断后 AMED 较高与 OC 患者 OS 改善相关，提示持续高摄入 AMED 可能有益于 OC 的预后。
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