Poster Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2023

Association of protein intake with recurrence and survival following primary treatment of ovarian cancer (#275)

Lizzy Johnston 1 2 3 , Torukiri Ibiebele 3 , Michael Friedlander 4 5 , Peter Grant 6 , Jolieke van der Pols 2 3 , Penelope Webb 3
  1. Cancer Council Queensland, Fortitude Valley, QLD, Australia
  2. School of Exercise and Nutrition Sciences, Queensland University of Technology, Kelvin Grove, QLD, Australia
  3. Population Health Program, QIMR Berghofer Medical Research Institute, Herston, QLD, Australia
  4. University of New South Wales Clinical School, Prince of Wales Hospital, Randwick, NSW, Australia
  5. Department of Medical Oncology, Prince of Wales Hospital, Randwick, NSW, Australia
  6. Department of Gynaecological Oncology, Mercy Hospital for Women, Heidelberg, VIC, Australia

Aims: Malnutrition is common during treatment of ovarian cancer, and one in three patients report multiple symptoms affecting food intake post-treatment. Current knowledge regarding dietary intake post-treatment in relation to ovarian cancer survival is limited. General guidelines recommend cancer survivors maintain a higher level of protein intake to support recovery and minimise nutritional deficits. Therefore, this study investigated 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 ~12 months post-diagnosis using a validated food frequency questionnaire in an Australian cohort of women with invasive epithelial ovarian cancer. Disease recurrence and survival status were abstracted from medical records (median 4.9 years 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 months 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. No overall survival advantage was observed with a higher level of protein intake, although 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 vs. lowest tertiles). 

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.