Abstract
Background: Obesity which might be considered as the malnutrition of the developed world, has reached endemic proportions and its prevalence continues to increase, particularly in the affluent countries of Europe and the United states. By the year 2000, nearly two-thirds of adults in the United States and an increasing percentage of the population worldwide are overweight or obese as defined by the World Health Organization. Adiposity has strong effects on metabolic factors that may subsequently affect cancer risk; in particular, on circulating levels of peptide and steroid hormones and their binding factors. However, the association of body mass index (BMI) with prognostic factors and patient survival remains largely unknown and needs to be established. Methods: Clinicopathologic data of 114 lung cancer patients between 1995 and 1997 and 123 ovarian cancer patients between 1991 and 1999 who underwent initial surgical resection for primary tumor at National Taiwan University Hospital, Taipei, Taiwan were retrospectively collected. The BMI was used as measures of obesity and was analyzed as prognosticator of recurrence/metastasis and patients survival. Results: BMI was found to be associated with stage of ovarian cancer (P<0.05), but not associated with prognostic factors of lung cancer. Moreover, BMI was found to be associated with poor prognostic status of ovarian cancer (P<0.05) but not associated with outcome of lung cancer. Combination of BMI and stage, overweight/obese patients of ovarian cancer at advanced stage had even much poorer survival and prognostic status. In contrast, combination of BMI and smoking history did not have any correlation with clinic outcome of the lung cancer patients. Conclusion: The results taken together indicate that BMI is associated with stage, overall survival, and disease-free survival of ovarian cancer patients and overweight/obese ovarian cancer patients at advanced stage had the worst survival and prognostic status. This is the first report providing initial evidence for an association of adiposity with hormone-related ovarian cancer in Taiwan.