J Cancer 2016; 7(5):516-522. doi:10.7150/jca.13578 This issue

Research Paper

Metabolic Determinants and Anthropometric Indicators Impact Clinical-pathological Features in Epithelial Ovarian Cancer Patients

Patrizia Vici*1, Laura Pizzuti*1, Luigi Di Lauro1, Laura Conti2, Chiara Mandoj2, Anna Antenucci2, Giovanna Digiesi2, Domenico Sergi1, Antonella Amodio1, Paolo Marchetti3, Francesca Sperati4, Mario Valle5, Alfredo Garofalo5, Enrico Vizza6, Giacomo Corrado6, Cristina Vincenzoni6, Federica Tomao7, Ramy Kayal8, Annalise Marsella8, Mariantonia Carosi9, Barbara Antoniani9, Antonio Giordano10,11, Marcello Maugeri-Saccà*1,12, Maddalena Barba*1,12 ✉

1. Division of Medical Oncology 2, Regina Elena National Cancer Institute, Rome, Italy
2. Division of Clinical Pathology, Regina Elena National Cancer Institute, Rome, Italy
3. Oncology Unit, Sant'Andrea Hospital, La Sapienza University of Rome, Italy
4. Biostatistics Unit-Scientific Direction, Regina Elena National Cancer Institute, Rome, Italy
5. General Surgery, Regina Elena National Institute, Rome, Italy
6. Gynecological Oncology, Regina Elena National Cancer Institute, Rome, Italy
7. Department of Gynecologic Oncology, University “Sapienza”, Viale del Policlinico 155, 00161 Rome, Italy
8. Department of Radiology, Regina Elena National Cancer Institute, Rome, Italy
9. Department of Pathology, Regina Elena National Cancer Institute, Rome, Italy
10. Sbarro Institute for Cancer Research and Molecular Medicine e del Center for Biotechnology, College of Science and Technology, Temple University, Philadelphia, PA, USA
11. Department of Medicine, Surgery and Neurosciences, University of Siena, Siena, Italy
12. Scientific Direction, Regina Elena National Cancer Institute, Rome, Italy.
*Equal contributors

This is an open access article distributed under the terms of the Creative Commons Attribution (CC BY-NC) License. See http://ivyspring.com/terms for full terms and conditions.
Vici P, Pizzuti L, Di Lauro L, Conti L, Mandoj C, Antenucci A, Digiesi G, Sergi D, Amodio A, Marchetti P, Sperati F, Valle M, Garofalo A, Vizza E, Corrado G, Vincenzoni C, Tomao F, Kayal R, Marsella A, Carosi M, Antoniani B, Giordano A, Maugeri-Saccà M, Barba M. Metabolic Determinants and Anthropometric Indicators Impact Clinical-pathological Features in Epithelial Ovarian Cancer Patients. J Cancer 2016; 7(5):516-522. doi:10.7150/jca.13578. Available from https://www.jcancer.org/v07p0516.htm

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Background: Over the last twenty years, the efforts of the scientific community devoted to the comprehension and treatment of ovarian cancer have remained poorly remunerative, with the case-fatality ratio of this disease remaining disappointedly high. Limited knowledge of the basic principles regulating ovarian carcinogenesis and factors impacting the course of disease may significantly impair our ability to intervene in early stages and lessen our expectations in terms of treatment outcomes. In the present study, we sought to assess whether metabolic factors and anthropometric indicators, i.e., pre-treatment fasting glucose and body mass index, are associated with renown cancer related prognostic factors such as tumour stage and grade at diagnosis.

Materials and Methods: Study participants were 147 women diagnosed with epithelial ovarian cancer and treated with platinum based regimens and/or surgery at the Regina Elena National Cancer Institute of Rome, Italy. Glucose levels were assessed at the institutional laboratories on venous blood collected in overnight fasting conditions and prior to any therapeutic procedure. Stage was coded according to the FIGO staging system based on the results of the diagnostic workup, while tumour grade was locally assessed by an expert pathologist. Participants' characteristics were descriptively analyzed for the overall study population and in a subgroup of 70 patients for whom data on body mass index (BMI) were available. FIGO stage and grade were compared by categories of pre-treatment fasting glucose defined upon the median value, i.e., 89 mg/dl. The association of interest was tested in regression models including BMI.

Results: For the overall study population, patients in the lowest category of fasting glucose were significantly more likely to exhibit a FIGO stage III-IV at diagnosis compared with their counterpart in the highest glucose category (81.3 vs 66.7%, p: 0.021). Subgroup analysis in 70 patients with BMI data confirmed this association (81.5 vs 55.8, p: 0.049), which remained significant when tested in regression models including BMI (OR: 0.28 95% CI 0.086-0.89, p: 0.031). No relevant evidence emerged when testing the association between fasting glucose and tumour grade.

Conclusions: In patients diagnosed with epithelial ovarian cancer, pre-treatment glucose levels appear to be inversely associated with FIGO stage. Further studies are warranted to eventually confirm and correctly interpret the implications of this novel finding.

Keywords: epithelial ovarian cancer, fasting glucose, body mass index, FIGO stage, tumour grade