Pre- and post-diagnosis dietary patterns and overall survival in patients with epithelial ovarian cancer: a prospective cohort study

Abstract

Background

Previous studies have examined the associations between individual foods or nutrients, but few studies have considered dietary patterns associated with ovarian cancer (OC) survival.

Methods

In a prospective cohort study, we examined the association between pre-diagnosis and post-diagnosis overall diet, including changes from pre-diagnosis to post-diagnosis, and overall survival (OS) in 560 patients with OC. Dietary intake was collected using a valid 111-item food frequency questionnaire. Principal component analysis was performed to determine the dietary patterns. Cox proportional hazard regression models were used to assess the hazard ratio (HRs) and 95% confidence interval (CIs).

Results

Two dietary patterns were identified: Balanced and nutritious pattern and Energy-dense pattern. The highest tertile of the post-diagnosis Balanced and nutritious pattern scores was related to better OS compared with the lowest tertile (HR = 0.40, 95% CI = 0.17–0.95, P_trend < 0.05). However, no significant association between pre-diagnosis and post-diagnosis Energy-dense pattern scores and OS was observed. Compared to those who had persistently high Balanced and nutritious pattern scores, patients who changed from a high score of pre-diagnosis Balanced and nutritious pattern to low post-diagnosis, as well as those who shifted from a low to a high score, both had a decreased OS (HR_{high−low vs. high−high} = 1.91, 95% CI = 1.18–3.08; HR_{low−high vs. high−high} = 2.19, 95% CI = 1.24–3.86). Additionally, patients who changed from a high pre-diagnosis score to a low post-diagnosis score had a decreased OS compared to those with consistently low Energy-dense pattern scores (HR_{high−low vs. low−low} = 1.74, 95% CI = 1.06–2.84).

Conclusions

Greater adherence to the Balanced and nutritious pattern as well as less adherence to the Energy-dense pattern from pre-diagnosis to post-diagnosis were associated with better OC survival.