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Journal of Immunology Research
Volume 2014, Article ID 349546, 8 pages
Research Article

Impact of Underweight after Treatment on Prognosis of Advanced-Stage Ovarian Cancer

1Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul 110-744, Republic of Korea
2Department of Obstetrics and Gynecology, Korean Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul 139-706, Republic of Korea
3Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seongnam 463-707, Republic of Korea
4Cancer Research Institute, Seoul National University College of Medicine, Seoul 110-799, Republic of Korea
5World Class University, Seoul National University, Seoul 151-921, Republic of Korea

Received 11 January 2014; Accepted 26 May 2014; Published 24 June 2014

Academic Editor: Bin Zhang

Copyright © 2014 Se Ik Kim et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


This study aimed to investigate the impact of underweight status on the prognosis of advanced-stage ovarian cancer. A total of 360 patients with stage III-IV epithelial ovarian cancer were enrolled and divided into three groups by body mass indexes (BMIs): underweight (BMI < 18.5 kg/m2); normal weight to overweight (18.5 kg/m2 BMI < 27.5 kg/m2); obesity (BMI ≥ 27.5 kg/m2). Progression-free survival (PFS), overall survival (OS), CA-125, and neutrophil to lymphocyte ratio (NLR) as a marker reflecting host inflammation and immunity were compared among the three groups according to the three treatment times: at diagnosis; after surgery; and after treatment. Only underweight status after treatment was associated with poor OS in comparison with normal weight to overweight or obesity (mean value, 44.9 versus 78.8 or 67.4 months; ); it was also an unfavorable factor for OS (adjusted HR, 2.29; 95% CI, 1.08–4.85). Furthermore, NLR was higher in patients with underweight than in those with obesity after treatment (median value, 2.15 versus 1.47; ), in spite of no difference in CA-125 among the three groups at the three treatment times. In conclusion, underweight status after treatment may be a poor prognostic factor in patients with advanced-stage ovarian cancer, which accompanies increased host inflammation and decreased immunity.