Diet and survival after a diagnosis of ovarian cancer: a pooled analysis from the Ovarian Cancer Association Consortium
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Prognosis after a diagnosis of invasive epithelial ovarian cancer is poor. Some studies have suggested modifiable behaviors, like diet, are associated with survival but the evidence is inconsistent. This study aims to pool data from studies conducted around the world to evaluate the relationships among dietary indices, foods, and nutrients from food sources and survival after a diagnosis of ovarian cancer. This analysis from the Multidisciplinary Ovarian Cancer Outcomes Group within the Ovarian Cancer Association Consortium included 13 studies with 7700 individuals with ovarian cancer, who completed food-frequency questionnaires regarding their prediagnosis diet. Adjusted hazard ratios (aHRs) and 95% confidence intervals (CI) for associations with overall survival were estimated using Cox proportional hazards models. Overall, there was no association between any of the 7 dietary indices (representing prediagnosis diet) evaluated and survival; however, associations differed by tumor stage. Although there were no consistent associations among those with advanced disease, among those with earlier stage (local/regional) disease, higher scores on the alternate Healthy Eating Index (aHR quartile 4 compared with 1 = 0.66, 95% CI: 0.50, 0.87), Healthy Eating Index-2015 (aHR: 0.75; 95% CI: 0.59, 0.97), and alternate Mediterranean diet (aHR: 0.76; 95% CI: 0.60, 0.98) were associated with better survival. Better survival was also observed for individuals with early-stage disease who reported higher intakes of dietary components that contribute to the healthy diet indices (aHR for Q4 compared with Q1: vegetables 0.71; 95% CI: 0.56, 0.91), tomatoes (aHR: 0.72; 95% CI: 0.57, 0.91) and nuts and seeds (aHR 0.71; 95% CI: 0.55, 0.92). In contrast, there were suggestions of worse survival with higher scores on 2 of the 3 inflammatory indices and higher intake of trans-fatty acids. Adherence to a more healthy, less-inflammatory diet may confer a survival benefit for individuals with early-stage ovarian cancer.
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Northern California Cooperative Family Registry for Breast CancerEpidemiology of Ovarian Cancer:New HypothesesCancer Center AdministrationObesity in ovarian cancer prognosisDana-Farber/Harvard Cancer Center Ovarian Cancer SPOREPathologyOvarian Cancer and Gonadotropin SignalingGenes, Hormones & Environment in an Ovarian Cancer ModelThe Molecular Epidemiology Of Ovarian CancerHormone Therapy and Risk of Ovarian CancerPhytoestrogens, alcohol, and endometrial cancer riskSteroid Hormone Genes and Ovarian Cancer RiskThe Progesterone Receptor Gene and Ovarian Cancer RiskCollaborative Genetic Study of Ovarian Cancer RiskCancer Research Training and Education CoordinationESTROGEN, DIET, GENETICS AND ENDOMETRIAL CANCEROvarian Cancer Australia FundingCancer Council Victoria FundingOvarian Cancer Research Fund FundingPeter MacCallum Cancer Foundation Ltd FundingNational Health and Medical Research Council FundingUS Army Medical Research and Materiel Command FundingDanish Cancer Society FundingNational Institutes of Health National Cancer Institute FundingUS Office of Congressionally Directed Medical Research Programs FundingVicHealth Funding