Association of pre- and post-diagnosis dietary total antioxidant capacity (TAC) and composite dietary antioxidant index (CDAI) with overall survival in patients with ovarian cancer: a prospective cohort study

• DOI: 10.1186/s12967-024-06041-6
• Publication Date: 2025-01-30T13:32:05Z
• Authors: Dong-Dong Wang; Ming-Qian Jia; He-Li Xu; Yu Li; Jia-Xin Liu; Jia-Cheng Liu; Jia-Nan Sun; Fan Cao; Lang Wu; Fang-Hua Liu; Yi-Zi Li; Yi-Fan Wei; Xiao-Ying Li; Qian Xiao; Song Gao; Dong-Hui Huang; Tao Zhang; Ting-Ting Gong; Qi-Jun Wu
• Keywords: Interquartile range

Abstract

Background The evidence on the relationship of dietary antioxidant nutrients with the survival of ovarian cancer (OC) remains scarce.

Objective This study aimed to investigate these associations in a prospective cohort of Chinese patients with OC.

Methods In this prospective cohort study, patients with epithelial OC completed a food frequency questionnaire at diagnosis and 12 months post-diagnosis, and were followed from 2015 to 2023. Dietary total antioxidant capacity (TAC) and composite dietary antioxidant index (CDAI) were calculated based on specific antioxidant nutrients. We examined the associations of pre-diagnosis, post-diagnosis, and changes from pre-diagnosis to post-diagnosis in TAC, CDAI, and representative antioxidant nutrients with overall survival (OS) among patients with OC. Multivariable Cox proportional-hazards models were applied to calculate the hazard ratios (HR) and 95% confidence intervals (CI). Dose–response relationships were evaluated by restricted cubic splines.

Results Among the total 560 patients with OC, there were 211 (37.68%) deaths during a median follow-up of 44.40 (interquartile range: 26.97–61.37) months. High pre-diagnosis TAC (HR = 0.58; 95% CI 0.38–0.8) and vitamin C intake (HRT3 vs. T1 = 0.36; 95% CI 0.21–0.61), and post-diagnosis TAC (HR = 0.57; 95% CI 0.37–0.8), CDAI (HR = 0.57; 95% CI 0.33–0.9), and β-carotene intake (HRT3 vs. T1 = 0.55; 95% CI 0.32–0.97) were significantly associated with improved OS. Compared to patients with constantly low pre- and post-diagnosis TAC and CDAI, those with consistently higher TAC (HRMedium-Medium vs. Low-Low = 0.53; 95% CI 0.29–0.97; HRHigh-High vs. Low-Low = 0.40; 95% CI 0.16–0.94) and CDAI (HRHigh-High vs. Low-Low = 0.33; 95% CI 0.12–0.88) experienced better OS.

Conclusion High pre- and post-diagnosis TAC, and post-diagnosis CDAI were associated with improved OC survival, suggesting that consistent high-intake of antioxidant-rich food may be beneficial for the prognosis of OC.