A healthy lifestyle and survival among women with ovarian cancer
Menée en Australie à partir de données portant sur 678 et 512 patientes atteintes d’un cancer de l’ovaire, cette étude de cohorte analyse l’impact, sur la survie, d’un mode de vie sain mesuré avant et après le diagnostic de la maladie, et défini par un indicateur prenant en compte les pratiques tabagiques, l’indice de masse corporelle, l’activité physique et la consommation d’alcool
Résumé en anglais
Ovarian cancer has a poor survival rate and, understandably, women often want to know whether there is anything they can do to improve their prognosis. Our goal was to investigate the association between a healthy lifestyle pre? and post?diagnosis and survival in a cohort of Australian women with invasive epithelial ovarian cancer. We calculated a healthy lifestyle index (HLI) based on women's self?reported smoking status, height, weight, physical activity, diet and alcohol consumption before diagnosis (n=678) and after completing primary treatment (n=512). Clinical data and vital status for each woman were ascertained through medical records. Cox proportional hazards regression was conducted to calculate hazard ratios (HR) and 95% confidence interval (CI) for all?cause mortality. There was a suggestive association between a more healthy lifestyle before diagnosis and better survival (HR 0.79, 95%CI: 0.59?1.04), however the association was stronger for lifestyle after diagnosis, with women in the highest tertile having significantly better survival than women in the lowest tertile (HR 0.61, 95%CI: 0.40?0.93; p?trend=0.02). Current smoking, particularly post?diagnosis, was associated with higher mortality (HR 1.68, 95%CI: 1.17?2.42; HR 2.82, 95%CI: 1.29?6.14, for pre? and post?diagnosis smoking respectively), but women who quit after diagnosis had survival outcomes similar to non?smokers (HR 0.99, 95%CI: 0.57?1.72). Higher physical activity after diagnosis was associated with better survival (HR 0.60, 95%CI: 0.39?0.92; p?trend 0.02). A healthy lifestyle after diagnosis, in particular not smoking and being physically active, may help women with ovarian cancer improve their prognosis.
