Evaluation of the relationship between patient's characteristics attributes and obesity-survival rate in ephitelial ovarian tumors

Aim: The aim of this study is to investigate the impact of obesity on overall and disease-free survival rates in patients diagnosed with ephitelial ovarian cancer. Beside, the effects of obesity on patient characteristics and other factors were also investigated. Materials and Methods: The files of 1053 patients which were diagnosed with ephitelial ovarian cancer between 1992 and 2018 in the Department of Obstetrics and Gynecology of Çukurova University, Balcalı Hospital were retrospectively analyzed. Among these patients, 939 patients whose anthropometric data could be accesed were included in the study. The BMI of these patients included in the study were calculated and they were categorized according to the obesity classification of the World Health Organization. In the analysis; patients' age range, body mass index, menopausal status, parity status, accompanying comorbidity, CA 125 values, amount of preoperational ascites, accompanying symptoms at the time of diagnosis, preoperational diameter of the tumor, type of the debulking surgery (primary-interval), adequacy of cytoreduction, primary type of operation, type of adjuvant chemotherapy, preoperative complication status, postoperative complication status, tumor histology, grade, and tumor stage were evaluated. SPSS (Statistical fort he Social Sciences) 23.0 package program was used for statistical analysis of the data. Categorical measurements were summarized as numbers and percentages, and continuous measurements were summarized as mean and standart deviation (also median and minimum-maxiumum where if needed). Chi-square and Fisher exact diagnostic tests were used to compare the categorical parameters. The Shaphiro-Wilk test was used to determine if the parameters in the study showed a normal distribution. Kaplan Meier test and Log Rank tests were used for survival analysis. Multiple logistic regression test was used to analyze the mortality effects of the patients. Statistical significance level was taken as 0.05 in all tests. Results: The mean age of the patients included in the study was 53,9±12,9 years, and it was determined that 347 of the patients were over the age of 65. Of the patients, 326 were premenopausal and 613 were postmenopausal. In our study, the mean survival and mean disease-free survival were found to be 71.9 months and 21.9 months. The mean overall survival course for the underweight, normal, overweight, obese and morbid obese patient was 49.7, 77.1, 75.5, 56.8, and 42.3 months. However the mean disease-free survival time was calculated as 16.2, 23.5, 24.7, 18.7 and 20.9 months. It was determined that the overall survival times of the patients in obese, morbid obese and underweight BMI categories were lower than the normal or overweight BMI groups (p=0,001). There was no significant difference between BMI groups in terms of disease-free survival. Conclusion: The prevalence of obesity is increasing in the developed world and it is an important public health problem worldwide. Considering that malignant diseases are one of the most common causes of death in developed countries and ovarian cancer is one of the deadliest types of malignancy in the female population, the effect of obesity on ovarian cancer prognosis and survival is worth examining. Although different results have been obtained in studies conducted since the past, comorbidities caused by obesity may have negative effects on the average survival rate of ovarian cancer. Keywords: ovarian cancers, ephitelial ovarian cancers, obesity, mortality, disease-free survival, total survival