Top

Published in:

01-12-2019 | Obesity | Gynecologic Oncology

Overweight and obesity do not determine worst prognosis in endometrioid endometrial carcinoma

Authors: Gabriela Villaça Chaves, Tatiana de Almeida Simao, Luis Felipe Ribeiro Pinto, Miguel Angelo Martins Moreira, Anke Bergmann, Claudia Bessa Pereira Chaves

Published in: Archives of Gynecology and Obstetrics | Issue 6/2019

Abstract

Purpose

The aim of this study was to investigate the impact of body mass index (BMI) on disease-free survival (DFS) and overall survival (OS) in women diagnosed with EEC and treated at the Brazilian National Cancer Institute.

Methods

The study comprised 849 women diagnosed with EEC who underwent surgical treatment between January, 2000 and December, 2011. The demographic and clinical characteristics of these patients were collected from medical records and their nutritional status was based on the BMI criteria. Univariate (OS and DFS) and multivariate analyses were performed using the Kaplan–Meier method and Cox proportional hazards models, respectively.

Results

About 83.2% of patients were obese or overweight at time of diagnosis, with a mean BMI of 31.83. Patients were followed for an average of 34.97 months. There were 111 recurrences (13.1%) and 140 deaths (16.5%), with mean DFS of 51.90 months and mean OS of 52.25 months. There was no significant association between BMI and DFS or OS. In multivariate analysis we did not find an increased hazard of recurrence or death among overweight or obese patients.

Conclusion

Overweight and obesity had no impact on EEC prognosis on the assessed cohort. Further studies are warranted.

Available only for authorised users

Global and Regional Estimates of the Incidence and Mortality for 38 Cancers: GLOBOCAN (2018) Lyon: International Agency for Research on Cancer/World Health Organization

Instituto Nacional de Cancer José Alencar Gomes da Silva 2018 INCA—Instituto Nacional de Câncer—Estimativa 2018 Ministério da Saúde Instituto Nacional de Cancer José Alencar Gomes da Silva 978-85-7318-283-5

Colombo N, Creutzberg C, Amant F et al (2016) ESMO-ESGO-ESTRO Consensus Conference on Endometrial Cancer: diagnosis, treatment and follow-up. Ann Oncol 27:16–41. https://doi.org/10.1093/annonc/mdv484 CrossRefPubMed

Greer BE, Koh W-J, Abu-Rustum N et al (2009) Uterine neoplasms. Clinical practice guidelines in oncology. J Natl Compr Cancer Netw 7:498–531CrossRef

World Cancer Research Fund and American Institute for Cancer Research (2007) Food, nutrition, physical activity, and the prevention of cancer: a global perspective. American Institute for Cancer Research, Washington

Renehan AG, Tyson M, Egger M et al (2008) Body-mass index and incidence of cancer: a systematic review and meta-analysis of prospective observational studies. Lancet (London, England) 371:569–578. https://doi.org/10.1016/S0140-6736(08)60269-X CrossRef

Renehan AG, Zwahlen M, Egger M (2015) Adiposity and cancer risk: new mechanistic insights from epidemiology. Nat Rev Cancer 15:484–498. https://doi.org/10.1038/nrc3967 CrossRefPubMed

Arem H, Irwin ML (2013) Obesity and endometrial cancer survival: a systematic review. Int J Obes (2005) 37:634–639. https://doi.org/10.1038/ijo.2012.94 CrossRef

Modesitt SC, Tian C, Kryscio R et al (2007) Impact of body mass index on treatment outcomes in endometrial cancer patients receiving doxorubicin and cisplatin: a gynecologic oncology group study. Gynecol Oncol 105:59–65. https://doi.org/10.1016/j.ygyno.2006.10.045 CrossRefPubMed

10.

von Gruenigen VE, Tian C, Frasure H et al (2006) Treatment effects, disease recurrence, and survival in obese women with early endometrial carcinoma : a gynecologic oncology group study. Cancer 107:2786–2791. https://doi.org/10.1002/cncr.22351 CrossRef

11.

Anderson B, Connor JP, Andrews JI et al (1996) Obesity and prognosis in endometrial cancer. Am J Obstet Gynecol 174:1171–1189CrossRef

12.

Everett E, Tamimi H, Greer B et al (2003) The effect of body mass index on clinical/pathologic features, surgical morbidity, and outcome in patients with endometrial cancer. Gynecol Oncol 90:150–157CrossRef

13.

Münstedt K, Wagner M, Kullmer U et al (2008) Influence of body mass index on prognosis in gynecological malignancies. Cancer Causes Control 19:909–916. https://doi.org/10.1007/s10552-008-9152-7 CrossRefPubMed

14.

Studzĩnski Z, Zajewski W (2003) Factors affecting the survival of 121 patients treated for endometrial carcinoma at a Polish hospital. Arch Gynecol Obstet 267:145–147. https://doi.org/10.1007/s00404-001-0288-x CrossRefPubMed

15.

Pecorelli S (2009) Revised FIGO staging for carcinoma of the vulva, cervix, and endometrium. Int J Gynaecol Obstet 105:103–104CrossRef

16.

World Health Organization (2000) Obesity: preventing and managing the global epidemic: Report of a WHO Consultation

17.

De Pergola G, Silvestris F (2013) Obesity as a major risk factor for cancer. J Obes 2013:291546. https://doi.org/10.1155/2013/291546 CrossRefPubMedPubMedCentral

18.

Calle EE, Kaaks R (2004) Overweight, obesity and cancer: epidemiological evidence and proposed mechanisms. Nat Rev Cancer 4:579–591. https://doi.org/10.1038/nrc1408 CrossRefPubMed

19.

Flegal KM, Carroll MD, Ogden CL, Johnson CL (2002) Prevalence and trends in obesity among US adults, 1999–2000. JAMA 288:1723–1727CrossRef

20.

Schouten LJ, Goldbohm RA, van den Brandt PA (2004) Anthropometry, physical activity, and endometrial cancer risk: results from the Netherlands Cohort Study. J Natl Cancer Inst 96:1635–1638. https://doi.org/10.1093/jnci/djh291 CrossRefPubMed

21.

Secord AA, Hasselblad V, Von Gruenigen VE et al (2016) Body mass index and mortality in endometrial cancer: a systematic review and meta-analysis. Gynecol Oncol 140:184–190. https://doi.org/10.1016/j.ygyno.2015.10.020 CrossRefPubMed

22.

Crosbie EJ, Zwahlen M, Kitchener HC et al (2010) Body mass index, hormone replacement therapy, and endometrial cancer risk: a meta-analysis. Cancer Epidemiol Biomark Prev 19:3119–3130. https://doi.org/10.1158/1055-9965.EPI-10-0832 CrossRef

23.

Arem H, Chlebowski R, Stefanick ML et al (2013) Body mass index, physical activity, and survival after endometrial cancer diagnosis: results from the Women’s Health Initiative. Gynecol Oncol 128:181–186. https://doi.org/10.1016/j.ygyno.2012.10.029 CrossRefPubMed

24.

Crosbie EJ, Roberts C, Qian W et al (2012) Body mass index does not influence post-treatment survival in early stage endometrial cancer: results from the MRC ASTEC trial. Eur J Cancer (Oxford, England : 1990) 48:853–864. https://doi.org/10.1016/j.ejca.2011.10.003 CrossRef

25.

Cespedes Feliciano EM, Kroenke CH, Meyerhardt JA et al (2016) Metabolic dysfunction, obesity, and survival among patients with early-stage colorectal cancer. J Clin Oncol. https://doi.org/10.1200/JCO.2016.67.4473 CrossRefPubMedPubMedCentral

26.

Temkin SM, Pezzullo JC, Hellmann M et al (2007) Is body mass index an independent risk factor of survival among patients with endometrial cancer? Am J Clin Oncol 30:8–14. https://doi.org/10.1097/01.coc.0000236047.42283.b8 CrossRefPubMed

27.

Mauland KK, Trovik J, Wik E et al (2011) High BMI is significantly associated with positive progesterone receptor status and clinico-pathological markers for non-aggressive disease in endometrial cancer. Br J Cancer 104:921–926. https://doi.org/10.1038/bjc.2011.46 CrossRefPubMedPubMedCentral

28.

Gates EJ, Hirschfield L, Matthews RP, Yap OWS (2006) Body mass index as a prognostic factor in endometrioid adenocarcinoma of the endometrium. J Natl Med Assoc 98:1814–1822PubMedPubMedCentral

29.

Jeong N-H, Lee J-M, Lee J-K et al (2010) Role of body mass index as a risk and prognostic factor of endometrioid uterine cancer in Korean women. Gynecol Oncol 118:24–28. https://doi.org/10.1016/j.ygyno.2010.03.001 CrossRefPubMed

30.

Amundson DE, Djurkovic S, Matwiyoff GN (2010) The obesity paradox. Crit Care Clin 26:583–596. https://doi.org/10.1016/j.ccc.2010.06.004 CrossRefPubMed

31.

Smits A, Lopes A, Das N et al (2015) The effect of lifestyle interventions on the quality of life of gynaecological cancer survivors: a systematic review and meta-analysis. Gynecol Oncol 139:546–552. https://doi.org/10.1016/j.ygyno.2015.10.002 CrossRefPubMed

32.

World Cancer Research Fund/American Institute for Cancer Research (2018) Diet, nutrition, physical activity and cancer: a global perspective. American Institute for Cancer Research, Washington

Title: Overweight and obesity do not determine worst prognosis in endometrioid endometrial carcinoma
Authors: Gabriela Villaça Chaves
Tatiana de Almeida Simao
Luis Felipe Ribeiro Pinto
Miguel Angelo Martins Moreira
Anke Bergmann
Claudia Bessa Pereira Chaves
Publication date: 01-12-2019
Publisher: Springer Berlin Heidelberg
Keywords: Obesity
Obesity
Endometrial Cancer
Endometrial Cancer
Overweight
Published in: Archives of Gynecology and Obstetrics / Issue 6/2019
Print ISSN: 0932-0067
Electronic ISSN: 1432-0711
DOI: https://doi.org/10.1007/s00404-019-05281-y

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Overweight and obesity do not determine worst prognosis in endometrioid endometrial carcinoma

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 6/2019

Preoperative morphological diagnosis of axillary lymph nodes in a breast center consultation service: evaluation of fine-needle aspiration and core biopsy techniques

Prospective randomized trial comparing efficacy of letrozole step-up protocol with letrozole plus gonadotropins for controlled ovarian stimulation and intrauterine insemination in patients with unexplained infertility

Long interpregnancy interval and mode of delivery

Frozen-thawed embryo transfer is better than fresh embryo transfer in GnRH antagonist cycle in women with 3–10 oocytes retrieved: a retrospective cohort study

Evaluation of the relationship between sexual functions and depressive symptoms among pregnant patients during the second trimester

Recurrent intrauterine growth restriction: characteristic placental histopathological features and association with prenatal vascular Doppler