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

Abstract

BACKGROUND: Prognosis following 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. OBJECTIVE(S): To pool data from studies conducted around the world to evaluate the relation between dietary indices, foods, and nutrients from food sources and survival after a diagnosis of ovarian cancer. METHOD(S): This analysis from the Multidisciplinary Ovarian Cancer Outcomes Group within the Ovarian Cancer Association Consortium included 13 studies with 7,700 individuals with ovarian cancer, who completed food-frequency questionnaires regarding their pre-diagnosis diet. Adjusted hazard ratios (aHR) and 95% confidence intervals (CI) for associations with overall survival were estimated using Cox proportional hazards models. RESULT(S): Overall, there was no association between any of the seven dietary indices (representing pre-diagnosis diet) evaluated and survival; however, associations differed by tumor stage. While 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 versus 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 versus 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 two of the three inflammatory indices and higher intake of trans-fatty acids. CONCLUSION(S): Adherence to a more heathy, less inflammatory diet may confer a survival benefit for individuals with early-stage ovarian cancer.Copyright © 2025. Published by Elsevier Inc.