Effect Of Ascites Volume And Obesity On Clinical Outcomes In Epithelial Ovarian Cancer

ObjectiveTo investigate the effect of ascites volume and obesity on clinicopathological characteristics and prognosis in patients with epithelial ovarian cancer（EOC）.MethodsCollected clinicopathological data of patients with EOC who were admitted to the First Affiliated Hospital of Chongqing Medical University from March 2011 to July 2018.Included patients were divided into three groups according to ascites volume at the initial surgery:no ascites（0mL,group A）,small volume ascites（<1500 mL,group B）and large volume ascites（≥1500 mL,group C）,the clinicopathological features（especially platinum sensitivity）,recurrence and survival were compared among the three groups.According to the Asian criteria for body mass index（BMI）at diagnosis,these patients were divided into non-obese group(BMI<25Kg/m²)and obese group（BMI≥25Kg/m²）,and compared the clinicopathological characteristics and survival prognosis between the two groups.ResultsA total of 546 patients with EOC were enrolled,141（25.8%）had large volume ascites.Preoperative CA125 level,pathological type,FIGO stage,residual disease,omental metastasis,and platinum sensitivity in group C were significantly different from those in group A and B（P<0.050）.There were significant differences in preoperative CA125 level,FIGO stage,residual disease,and omental metastasis between group A and group B.Prolonged PFI was associated with decreased ascites volume.Kaplan-Meier analysis showed large volume ascites group had shorter progression-free survival（PFS,P<0.001）and overall survival（OS,P<0.001）in univariate analysis.Considering ascites volume continuously,increasing each liter of ascites was associated with increased risks for disease recurrence（HR=1.115,95%CI:1.035-1.200;P=0.004）and death（HR=1.213 95%CI:1.090-1.350;P<0.001）in COX multivariate analysis.A total of 491 EOC patients were obtained BMI at diagnosis,of which120 were obese.There were significant differences in age,diabetes,hypertension,degree of differentiation,omental metastasis,and platinum sensitivity between obese group and non-obese group（P<0.050）.Kaplan-Meier analysis showed shorter PFS（P=0.013）and OS（P=0.007）in obese group.COX multivariate analysis suggested that obesity was not a predictor of recurrence（P=0.142）and death（P=0.126）in EOC patientsConclusionsThe volume of ascites at initial surgery was an independent predictor for PFS and OS in EOC patients.Large volume ascites shortened PFI and increased the occurrence of PPR.Obesity at diagnosis was associated with degree of tumor differentiation,platinumresistanceandotherclinicopathological characteristics of EOC patients,but was not an independent predictor for PFS and OS.