Association of Protein Intake with Recurrence and Survival Following Primary Treatment of Ovarian Cancer

Background: Malnutrition is common during treatment of ovarian cancer, and 1 in 3 patients report multiple symptoms affecting food intake after primary treatment. Little is known about diet posttreatment in relation to ovarian cancer survival; however, general recommendations for cancer survivors are to maintain a higher level of protein intake to support recovery and minimize nutritional deficits. Objectives: To investigate whether intake of protein and protein food sources following primary treatment of ovarian cancer is associated with recurrence and survival. Methods: Intake levels of protein and protein food groups were calculated from dietary data collected similar to 12 mo postdiagnosis using a validated FFQ in an Australian cohort of women with invasive epithelial ovarian cancer. Disease recurrence and survival status were abstracted from medical records (median 4.9 y follow-up). Cox proportional hazards regression was used to calculate adjusted HRs and 95% CIs for protein intake and progression-free and overall survival. Results: Among 591 women who were progression-free at 12 mo follow-up, 329 (56%) subsequently experienced cancer recurrence and 231 (39%) died. A higher level of protein intake was associated with better progression-free survival (>1-1.5 compared with <= 1 g/kg body weight, HRadjusted: 0.69, 95% CI: 0.48, 1.00; >1.5 compared with <= 1 g/kg, HRadjusted: 0.61, 95% CI: 0.41, 0.90; >20% compared with <= 20% total EI from protein, HRadjusted: 0.77, 95% CI: 0.61, 0.96). There was no evidence for better progression-free survival with any particular protein food sources. There was a suggestion of better overall survival among those with higher total intakes of animal-based protein foods, particularly dairy products (HR: 0.71; 95% CI: 0.51, 0.99 for highest compared with lowest tertiles of total dairy intake). Conclusions: After primary treatment of ovarian cancer, a higher level of protein intake may benefit progression-free survival. Ovarian cancer survivors should avoid dietary practices that limit intake of protein-rich foods.

Automated summary

Background: Malnutrition is common during treatment of ovarian cancer, and little is known about diet posttreatment in relation to ovarian cancer survival. Objectives: To investigate whether intake of protein and protein food sources following primary treatment of ovarian cancer is associated with recurrence and survival.