Diet and survival after a diagnosis of ovarian cancer: a pooled analysis from the Ovarian Cancer Association Consortium

IF 6.9 1区医学 Q1 NUTRITION & DIETETICS American Journal of Clinical Nutrition Pub Date : 2025-04-01 DOI:10.1016/j.ajcnut.2025.02.004

Christina M Nagle , Torukiri I Ibiebele , Renhua Na , Elisa V Bandera , Daniel Cramer , Jennifer A Doherty , Graham G Giles , Marc T Goodman , Gillian E Hanley , Holly R Harris , Allan Jensen , Susanne K Kjaer , Alice Lee , Valerie McGuire , Roger L Milne , Bo Qin , Jean Richardson , Naoko Sasamoto , Joellen M Schildkraut , Weiva Sieh , Penelope M Webb

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Abstract

Background

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.

Objectives

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.

Methods

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.

Results

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.

Conclusions

Adherence to a more healthy, less-inflammatory diet may confer a survival benefit for individuals with early-stage ovarian cancer.

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卵巢癌诊断后的饮食和生存：来自卵巢癌协会联合会的汇总分析。

背景：侵袭性上皮性卵巢癌诊断后预后较差。一些研究表明，饮食等可改变的行为与生存有关，但证据并不一致。目的：汇总来自世界各地的研究数据，以评估卵巢癌诊断后饮食指标、食物和食物来源中的营养素与生存之间的关系。方法：这项来自卵巢癌协会联盟的多学科卵巢癌预后组的分析包括13项研究，涉及7700名卵巢癌患者，他们完成了关于诊断前饮食的食物频率问卷。校正风险比（aHR）和与总生存率相关的95%置信区间（CI）使用Cox比例风险模型进行估计。结果：总体而言，评估的七个饮食指标（代表诊断前饮食）与生存之间没有任何关联；然而，这种关联因肿瘤分期而异。虽然在晚期疾病患者中没有一致的关联，但在早期（局部/区域）疾病患者中，替代健康饮食指数得分较高（aHR四分位数4对1 = 0.66,95% CI=0.50, 0.87），健康饮食指数-2015 (aHR 0.75；95% CI=0.59, 0.97)和替代地中海饮食(aHR 0.76；95% CI=0.60, 0.98)与较好的生存率相关。报告摄入有助于健康饮食指数的膳食成分较高的早期疾病患者的生存率也较高(第四季度aHR vs第一季度aHR：蔬菜0.71；95% CI=0.56, 0.91)，西红柿(aHR 0.72；95% CI=0.57, 0.91)和坚果和种子(aHR 0.71；95% ci =0.55, 0.92)。相反，三个炎症指数中的两个得分越高，反式脂肪酸摄入量越高，生存率越差。结论：坚持更健康、更少炎症的饮食可能会给早期卵巢癌患者带来生存益处。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

American Journal of Clinical Nutrition 医学-营养学

CiteScore

12.40

自引率

4.20%

发文量

332

审稿时长

38 days

期刊介绍： American Journal of Clinical Nutrition is recognized as the most highly rated peer-reviewed, primary research journal in nutrition and dietetics.It focuses on publishing the latest research on various topics in nutrition, including but not limited to obesity, vitamins and minerals, nutrition and disease, and energy metabolism. Purpose: The purpose of AJCN is to: Publish original research studies relevant to human and clinical nutrition. Consider well-controlled clinical studies describing scientific mechanisms, efficacy, and safety of dietary interventions in the context of disease prevention or health benefits. Encourage public health and epidemiologic studies relevant to human nutrition. Promote innovative investigations of nutritional questions employing epigenetic, genomic, proteomic, and metabolomic approaches. Include solicited editorials, book reviews, solicited or unsolicited review articles, invited controversy position papers, and letters to the Editor related to prior AJCN articles. Peer Review Process: All submitted material with scientific content undergoes peer review by the Editors or their designees before acceptance for publication.