The effects of obesity on surgical complications and postoperative prognosis of epithelial ovarian cancer: a meta-analysis

Abstract Objective To comprehensivelyevaluate and compare surgical outcomes of obese patients versus non-obese patients for surgical complications and postoperative prognosis due to epithelial ovarian cancer. Methods Studies were obtained from database search systems of, Medline (PubMed) and Embase. Data were analyzed by the meta-analysis method and the random-effect or fixed-effect model. The heterogeneity between the studies was evaluated by I2 index and the data were analyzed using STATA version 15.1 and Review Manager version 5.4. Results 14 studies with 4858 cases of proven epithelial ovarian cancer who underwent extensive surgery were included. Obesity may be a risk factor of the low surgical complex score (RR 1.08, 95% CI 1.01–1.15, p = 0.05), but had no manifesting difference in the surgical complications scorecompared non-obesity group (RR 0.50, 95% CI 0.07–3.79, p = 0.501 and RR 0.60, 95% CI 0.22–1.63,p = 0.316). Obesity EOC patients who undergone surgery tended to be correlated with surgical complications, such as wound infection (RR 2.71, 95% CI 1.59-4.61, p = 0.000), intestinal complications (RR 2.09, 95% CI 1.00-4.35, p = 0.000), and 30-readmission rate (RR 1.84, 95% CI 1.16-2.93, p = 0.000). Obese patients were more likely to have shorter prognosis free survival (PFS) (SMD0.62-year, 95% CI − 0.13 to 0.15), but the results did not discover a significant difference in overall survival (OS)between obesity and non-obesity. (SMD 0.01-year, 95% CI − 0.13 to 0.15) Conclusions Obesity affects the difficulty of ovarian cancer surgery, and a negative relationship between obesity and surgical complications is observed. Obesity is a potential risk factor for prognosis of EOC patients. Attention is played on determining what kind of case should be benefit most from this surgery to minimize the rates of operativecomplications and postoperative mortality. PROSPERO registration number: CRD 42023434781