Metabolic Syndrome Predicts Chemotherapy Resistance and Poor Prognosis in Epithelial Ovarian Cancer: A Retrospective Observational Cohort Study.

OBJECTIVE

This study aimed to evaluate the association between metabolic syndrome and chemotherapy resistance, as well as its prognostic significance in patients with epithelial ovarian cancer.

MATERIALS AND

METHODS

This single-center retrospective observational cohort study analyzed clinical data from 513 patients with histologically confirmed epithelial ovarian cancer who underwent cytoreductive surgery followed by standard platinum-based chemotherapy at The First Affiliated Hospital of Chengdu Medical College between January 2019 and December 2021. Metabolic syndrome was diagnosed according to the International Diabetes Federation criteria. Follow-up data were collected through outpatient visits and telephone interviews, and overall survival and progression-free survival were recorded. Survival outcomes were evaluated using Kaplan-Meier analysis. Multivariable Cox proportional hazards regression models were employed to identify independent prognostic factors after adjustment for clinically relevant confounders, including age, histological subtype, FIGO stage, surgical completeness, chemotherapy response, and maintenance therapy.

RESULTS

Among the 513 included patients, 180 (35.09%) were diagnosed with metabolic syndrome. Patients with metabolic syndrome had significantly higher body mass index, advanced FIGO stages, higher prevalence of diabetes, hypertension, dyslipidemia, and higher rates of chemotherapy resistance compared to those without metabolic syndrome. Kaplan-Meier analysis showed that patients with metabolic syndrome had significantly shorter overall survival and progression-free survival compared with patients without metabolic syndrome. In multivariable Cox regression analysis, metabolic syndrome remained independently associated with poorer overall survival and progression-free survival after adjustment for potential confounding factors.

CONCLUSION

Metabolic syndrome is significantly associated with chemotherapy resistance and poor prognosis in patients with epithelial ovarian cancer. These findings suggest that metabolic syndrome may serve as a useful clinical indicator for risk stratification. However, because this was a single-center retrospective observational study, causal relationships cannot be established. Further prospective multicenter studies are warranted to validate these findings.