abstract
INTRODUCTION:
Despite strides in identifying factors that predict risk of
ovarian cancer and improvements in
ovarian cancer treatment, little is known about factors that predict
ovarian cancer survival.
METHODS:
We
reviewed the literature for analyses of factors
before, at, or after
diagnosis that may predict survival outcomes, including demographics
(e.g., age and race), genetics (e.g., inherited BRCA mutations),
hormonal factors (e.g., parity and hormone use), and lifestyle (e.g.,
physical activity and diet).
RESULTS:
While
treatment factors, tumor characteristics and genetic syndromes are
predictive of survival, few studies of most hormonal and lifestyle
factors have been published;
most have evaluated pre-diagnosis factors.
For example, we identified eight studies that examined menopausal
hormone use prior to diagnosis, reporting a non-significant survival
benefit for users compared to non-users, while four studies reported
better survival with use after surgery, though only two were
significant. Similarly, while increased body size has been extensively
studied as potentially associated with reduced survival, other
modifiable factors, such as diet and physical activity remain
understudied. We identified three studies of pre-diagnosis physical
activity and five studies of pre-diagnosis diet, with a suggestive
benefit of higher vegetable intake and vigorous physical activity. By
contrast, large studies of the impact of race/ethnicity and
socioeconomic status (SES) confirm that non-white women and women of
lower SES fare more poorly than white women and women of higher SES,
respectively.
CONCLUSIONS:
Our review of the published literature on predictors of
ovarian cancer
survival revealed that modifiable lifestyle factors may be related to
survival, but that hormonal factors do not strongly predict outcomes in
ovarian cancer
patients.
However, more attention should be paid to women's
post-diagnosis survival experience. The dearth of literature on
post-diagnosis factors that may improve outcomes makes it difficult to
make specific recommendations for survivors.
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