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

Journal Article (Journal Article)


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.


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.


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.


Higher BMI is associated with adverse survival among the majority of women with ovarian cancer.

Full Text

Duke Authors

Cited Authors

  • Nagle, CM; Dixon, SC; Jensen, A; Kjaer, SK; Modugno, F; deFazio, A; Fereday, S; Hung, J; Johnatty, SE; Australian Ovarian Cancer Study Group, ; Fasching, PA; Beckmann, MW; Lambrechts, D; Vergote, I; Van Nieuwenhuysen, E; Lambrechts, S; Risch, HA; Rossing, MA; Doherty, JA; Wicklund, KG; Chang-Claude, J; Goodman, MT; Ness, RB; Moysich, K; Heitz, F; du Bois, A; Harter, P; Schwaab, I; Matsuo, K; Hosono, S; Goode, EL; Vierkant, RA; Larson, MC; Fridley, BL; Høgdall, C; Schildkraut, JM; Weber, RP; Cramer, DW; Terry, KL; Bandera, EV; Paddock, L; Rodriguez-Rodriguez, L; Wentzensen, N; Yang, HP; Brinton, LA; Lissowska, J; Høgdall, E; Lundvall, L; Whittemore, A; McGuire, V; Sieh, W; Rothstein, J; Sutphen, R; Anton-Culver, H; Ziogas, A; Pearce, CL; Wu, AH; Webb, PM; Ovarian Cancer Association Consortium,

Published Date

  • September 2015

Published In

Volume / Issue

  • 113 / 5

Start / End Page

  • 817 - 826

PubMed ID

  • 26151456

Pubmed Central ID

  • PMC4559823

Electronic International Standard Serial Number (EISSN)

  • 1532-1827

International Standard Serial Number (ISSN)

  • 0007-0920

Digital Object Identifier (DOI)

  • 10.1038/bjc.2015.245


  • eng