The role of diet, obesity and body composition in epithelial ovarian cancer development and progression: Mechanisms and therapeutic implications.

Epithelial ovarian cancer (EOC) ranks among the deadliest cancers, with over half of newly diagnosed patients presenting with metastatic disease, highlighting the need for early detection strategies and a deeper understanding of biologic factors that impact EOC progression and treatment response. This paper aims to synthesize the current literature on the association between diet, obesity, and body composition and EOC prognosis, drawing on translational, molecular, and clinical studies to identify gaps in research and inform preventative strategies to improve outcomes in EOC patients. The current literature on the association between diet and EOC prognosis suggests a role for several dietary interventions in the prevention of EOC development and progression, including increased intake of animal-based proteins (specifically dairy products), fiber-rich foods, cruciferous vegetables, and polyunsaturated fats, and ongoing clinical trials examine variations of intermittent fasting and fasting-mimicking diets in EOC patients. However, the impact of diet and nutritional interventions on survival and therapeutic response in EOC remains largely understudied, and low quality of evidence in this area limits the ability to form comprehensive dietary recommendations. Therefore, this study calls for future research in this area to inform dietary recommendations with the ultimate goals of improving patient outcomes and quality of life. Additionally, obesity and high-fat diets may contribute to EOC progression through chronic low-grade inflammation, and consideration of body composition and adiposity may impact intervention parameters and should be investigated in future research.