Table 3. BMI before and at diagnosis and overall and ovarian cancer-specific mortality by stage (KP-ROCS Study, 2000–2014)a.
| Stage I/II | Stage III | Stage IV | ||||
|---|---|---|---|---|---|---|
| HRb (95% CI) | HRc (95% CI) | HRb (95% CI) | HRc (95% CI) | HRb (95% CI) | HRc (95% CI) | |
|
Overall mortality | ||||||
| Prediagnosis BMI (kg m−2) | n/events: 345/60 | 334/56 | 501/292 | 458/256 | 310/240 | 278/213 |
| Normal (18.5–24.99) | 1 (reference) | 1 (reference) | 1 (reference) | 1 (reference) | 1 (reference) | 1 (reference) |
| Overweight (25–29.99) | 0.36 (0.15–0.88) | 0.33 (0.13–0.87) | 0.83 (0.60–1.15) | 0.79 (0.55–1.13) | 0.80 (0.56–1.14) | 0.73 (0.49–1.08) |
| Obese I (30–34.99) | 0.76 (0.31–1.88) | 0.93 (0.37–2.35) | 1.52 (1.04–2.22) | 1.35 (0.90–2.02) | 0.65 (0.42–1.00) | 0.63 (0.40–1.01) |
| Obese II/III (⩾35) | 1.85 (0.76–4.47) | 1.71 (0.69–4.28) | 1.12 (0.74–1.72) | 1.14 (0.71–1.84) | 0.56 (0.35–0.89) | 0.54 (0.33–0.88) |
| Pinteraction | 0.002 | 0.001 | ||||
| At-diagnosis BMI (kg m−2) | n/events: 345/59 | 334/55 | 494/288 | 453/253 | 306/236 | 276/210 |
| Normal (18.5–24.99) | 1 (reference) | 1 (reference) | 1 (reference) | 1 (reference) | 1 (reference) | 1 (reference) |
| Overweight (25–29.99) | 0.38 (0.15–0.92) | 0.40 (0.15–1.05) | 0.98 (0.72–1.34) | 0.90 (0.64–1.27) | 0.74 (0.52–1.06) | 0.77 (0.52–1.14) |
| Obese I (30–34.99) | 0.99 (0.40–2.48) | 1.14 (0.45–2.90) | 1.28 (0.86–1.89) | 1.01 (0.66–1.55) | 0.78 (0.51–1.20) | 0.83 (0.52–1.31) |
| Obese II/III (⩾35) | 1.97 (0.75–5.14) | 1.93 (0.74–5.05) | 1.30 (0.86–1.96) | 1.18 (0.74–1.88) | 0.54 (0.32–0.91) | 0.56 (0.32–0.98) |
| Pinteraction | 0.003 | 0.002 | ||||
|
Ovarian cancer-specific mortality | ||||||
| Prediagnosis BMI (kg m−2) | n/events: 345/42 | 334/39 | 501/257 | 458/223 | 310/203 | 278/181 |
| Normal (18.5–24.99) | 1 (reference) | 1 (reference) | 1 (reference) | 1 (reference) | 1 (reference) | 1 (reference) |
| Overweight (25–29.99) | 0.55 (0.19–1.61) | 0.49 (0.15–1.61) | 0.75 (0.53–1.05) | 0.69 (0.47–1.00) | 0.87 (0.59–1.28) | 0.84 (0.55–1.28) |
| Obese I (30–34.99) | 0.79 (0.25–2.53) | 0.88 (0.26–2.97) | 1.28 (0.86–1.93) | 1.12 (0.72–1.73) | 0.65 (0.40–1.04) | 0.67 (0.40–1.11) |
| Obese II/III (⩾35) | 3.40 (1.16–9.99) | 2.80 (0.88–8.93) | 1.02 (0.65–1.59) | 1.01 (0.61–1.68) | 0.58 (0.35–0.96) | 0.58 (0.34–1.00) |
| Pinteraction | 0.003 | 0.005 | ||||
| At-diagnosis BMI (kg m−2) | n/events: 345/41 | 334/38 | 494/254 | 453/221 | 306/200 | 276/179 |
| Normal (18.5–24.99) | 1 (reference) | 1 (reference) | 1 (reference) | 1 (reference) | 1 (reference) | 1 (reference) |
| Overweight (25–29.99) | 0.51 (0.18–1.44) | 0.57 (0.18–1.75) | 0.91 (0.66–1.26) | 0.80 (0.56–1.15) | 0.78 (0.53–1.14) | 0.84 (0.56–1.27) |
| Obese I (30–34.99) | 1.05 (0.33–3.32) | 1.08 (0.32–3.58) | 1.11 (0.73–1.68) | 0.82 (0.52–1.29) | 0.68 (0.43–1.09) | 0.79 (0.48–1.31) |
| Obese II/III (⩾35) | 3.22 (1.02–10.15) | 2.79 (0.85–9.19) | 1.15 (0.74–1.79) | 1.00 (0.60–1.64) | 0.50 (0.28–0.90) | 0.55 (0.30–1.01) |
| Pinteraction | 0.001 | 0.001 | ||||
Abbreviations: BMI=body mass index; CA125=cancer antigen 125; CI=confidence interval; CVD=cardiovascular disease; KP-ROCS=Kaiser Permanente Research on Ovarian Cancer Survival; HR=hazard ratio.
P-value for interactions are for BMI × stage at diagnosis for the two models.
a
Underweight women (n=10 for ‘prediagnosis’/n=21 for ‘at diagnosis’ analyses) were excluded.
b
Adjusted for age at diagnosis, race/ethnicity, histology, grade, and time to diagnosis (months), diabetes, hypertension, CVD, renal disease, post-treatment CA125, chemotherapy (no, carboplatin+paclitaxel, other regimen), and type of surgery.
c
Further adjusted for ascites and bowel obstruction and excluding women with cachexia.