Goldenberg Carlye, Krell Kavita, Miranda Edgar Diaz, Ko Sooah, Demirchian Maya, Dyer Grace Anne, Hunter Mark, Tuller Erin, Hull Amanda, Lei Lei
School of Medicine, University of Missouri. Columbia, Missouri, 65201.
Department of Obstetrics, Gynecology and Women's Health, School of Medicine, University of Missouri. Columbia, Missouri, 65201.
medRxiv. 2025 Jun 20:2025.06.18.25329863. doi: 10.1101/2025.06.18.25329863.
This study examined how obesity, smoking, and pregnancy history, characterized as lifestyle factors, are associated with survival of epithelial ovarian cancer, and investigated whether epithelial ovarian cancer presentation, survival, and cancer recurrence are affected by patient home geographic location.
A retrospective analysis was conducted on all patients with epithelial ovarian cancer treated at the University of Missouri and Ellis Fischel Cancer Center between 2008 and 2023. Patient charts were reviewed for cancer history, lifestyle factors, patient status, laboratory values, and residential zip codes which were categorized using Missouri ZIP Health Rankings. Survival, cox univariate and multivariate logistic regression, and association analyses were performed.
In this cohort, stage at diagnosis, histologic type, age at diagnosis and initial CA125 proved to be significant predictors of survival, while lifestyle factors including BMI, smoking, and pregnancy were not. Notably, patients residing in communities with the lowest zip code health rankings experienced higher rates of cancer recurrence, despite a lower overall number of cases compared to higher-ranked communities.
Although the lifestyle factors investigated in this study were not significantly associated with survival, a geographic disparity in recurrence rates and total cases was clear, suggesting possible underdiagnosis and barriers to accessing care in lower ranked zip codes. These findings emphasize an evident need to further investigate community-specific healthcare access and delivery, as well as other lifestyle factors that may be contributing to these differences.
本研究探讨了肥胖、吸烟和妊娠史等生活方式因素与上皮性卵巢癌生存率之间的关联，并调查了患者的家庭地理位置是否会影响上皮性卵巢癌的发病情况、生存率及癌症复发情况。
对2008年至2023年期间在密苏里大学和埃利斯·菲舍尔癌症中心接受治疗的所有上皮性卵巢癌患者进行回顾性分析。查阅患者病历，了解癌症病史、生活方式因素、患者状况、实验室检查值以及居住邮政编码，并根据密苏里州邮政编码健康排名进行分类。进行了生存分析、Cox单因素和多因素逻辑回归分析以及关联分析。
在该队列中，诊断时的分期、组织学类型、诊断年龄和初始CA125被证明是生存的重要预测因素，而包括体重指数、吸烟和妊娠在内的生活方式因素则不是。值得注意的是，居住在邮政编码健康排名最低社区的患者癌症复发率较高，尽管与排名较高的社区相比，病例总数较少。
尽管本研究中调查的生活方式因素与生存率没有显著关联，但复发率和病例总数在地理上存在明显差异，这表明在排名较低的邮政编码地区可能存在诊断不足和就医障碍。这些发现强调了迫切需要进一步调查社区特定的医疗服务获取和提供情况，以及可能导致这些差异的其他生活方式因素。
