Impact of Obesity on Treatment and Survival Outcome in Epithelial Ovarian Cancer Patients: A 10-year retrospective study

Abstract

Objectives: To assess the influence of women with obesity on surgical outcomes, chemotherapy side effects, and survival rates in Thai patients with epithelial ovarian cancer. Materials and Methods: A retrospective review was conducted of the medical records of patients with epithelial ovarian cancer who underwent staging laparotomy at Siriraj Hospital between January 2008 and December 2017. Patients were categorized as patients without obesity (body mass index [BMI] < 25.0 kg/m²) or patient with obesity (BMI ≥ 25 kg/m²) according to the Western Pacific Regional Office BMI criteria.We compared patient demographics, surgical outcomes, chemotherapy complications, and survival data between the two groups. Results: From an initial cohort of 444 patients, 18 were excluded, leaving 426 for analysis. The women with obesity group, representing 21.9% (n = 93) of the patients, exhibited a higher prevalence of diabetes mellitus (p < 0.0001), hypertension (p = 0.003), and dyslipidemia (p = 0.027) than the women without obesity group (78.1%, n = 333). Patients with obesity were significantly associated with increased postoperative complications, notably wound issues (adjusted odds ratio [OR] 6.175, 95% confidence interval [CI] 1.891–13.191; p < 0.001) and venous thromboembolism (adjusted OR 5.991, 95% CI 2.848–12.605; p < 0.001), but it correlated with fewer cases of neutropenia (p = 0.002) and reduced delays in chemotherapy (p = 0.015). There were no significant differences in progression-free survival (p = 0.135) or five-year overall survival (p = 0.923). Conclusion: Thai women with obesity with epithelial ovarian cancer was linked to an increased risk of postoperative complications, increased chemotherapy tolerability, but did not affect survival outcomes.