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Cancer Causes & Control

Published in:

01-11-2008 | Original Paper

Influence of body mass index on prognosis in gynecological malignancies

Authors: Karsten Münstedt, Mathias Wagner, Uwe Kullmer, Andreas Hackethal, Folker E. Franke

Published in: Cancer Causes & Control | Issue 9/2008

Abstract

Objective

To evaluate the effect of obesity on the presentation and course of disease in patients with gynecological cancers.

Study design

Records of patients with endometrial (n = 1180), cervical (n = 738), and ovarian cancer (n = 824) treated between 1986 and 2005 were reviewed. Body mass index (BMI) was analyzed in relation to tumor stage, tumor grading, and prognosis. Steroid hormone receptor status and growth fraction (MIB1; Ki-67-antigen) of tumors in relation to BMI were analyzed in subgroups with endometrial (n = 183) and advanced ovarian (n = 221) cancers. In the latter subgroup, tumor vascularization (CD31) and expression of bcl-2, c-erb-B2, fibronectin, and tumor markers (CA-125, CA15-3, CEA) were also evaluated. Statistical analyses included bivariate correlation, cross-tabulation, Kaplan-Meier-survival analyses, and multifactorial residual survival analyses.

Results

Obese patients with endometrial carcinoma were significantly younger (p < 0.001) and their tumors were less advanced at diagnosis (p = 0.001) and were better differentiated (p = 0.010). In the subgroups, neither steroid hormone receptor status nor MIB1-determined growth fraction correlated with BMI. For both endometrial and cervical carcinomas, a high BMI influenced overall survival favorably (p _endometrial= 0.004 and p _cervical= 0.026). In ovarian cancer, there was a trend toward improved survival in more obese patients (p = 0.053). Immunohistochemistry revealed that c-erb-B2 expression was slightly lower in tumors of obese patients (r = −0.142; p = 0.039), but BMI did not influence any other factor.

Conclusions

Although obesity increases the incidence of cancer, a high BMI does not seem to adversely influence the prognosis in patients with the mentioned gynecological malignancies.

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Title: Influence of body mass index on prognosis in gynecological malignancies
Authors: Karsten Münstedt
Mathias Wagner
Uwe Kullmer
Andreas Hackethal
Folker E. Franke
Publication date: 01-11-2008
Publisher: Springer Netherlands
Published in: Cancer Causes & Control / Issue 9/2008
Print ISSN: 0957-5243
Electronic ISSN: 1573-7225
DOI: https://doi.org/10.1007/s10552-008-9152-7

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Abstract

Objective

Study design

Results

Conclusions

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