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Published in: Annals of Surgical Oncology 9/2016

01-09-2016 | Gynecologic Oncology

Weight Change Pattern and Survival Outcome of Women with Endometrial Cancer

Authors: Koji Matsuo, MD, PhD, Aida Moeini, MD, Sigita S. Cahoon, MD, Hiroko Machida, MD, Marcia A. Ciccone, MD, Brendan H. Grubbs, MD, Laila I. Muderspach, MD

Published in: Annals of Surgical Oncology | Issue 9/2016

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Abstract

Objective

The aim of this study was to determine the association between weight change patterns and survival outcomes of women with endometrial cancer.

Methods

This retrospective study examined surgically-staged endometrial cancer cases with available weight information between 1999 and 2013 (n = 665). Proportional body mass index (delta-BMI) change at 6 months, 1 and 2 years after hysterectomy was compared with baseline BMI and correlated to patient demographics, tumor characteristics, treatment type, and disease-free survival (DFS) and overall survival (OS).

Results

Mean BMI was 35.6, and 69 % of cases were obese. At 6 months, 1 and 2 years after surgery, 39.1, 51.6, and 57.0 % of the study population, respectively, gained weight compared with pre-treatment baseline. In univariate analysis, 6-month delta-BMI change was significantly associated with DFS and OS, demonstrating bidirectional effects (both p < 0.001): 5-year rates, ≥15.0 % delta-BMI loss (33.5 and 59.1 %), 7.5–14.9 % loss (67.3 and 70.0 %), <7.5 % loss (87.8 and 95.7 %), <7.5 % gain (87.2 and 90.3 %), 7.5–14.9 % gain (64.6 and 67.6 %), and ≥15.0 % gain (32.5 and 66.7 %). In multivariable analysis controlling for age, ethnicity, baseline BMI, histology, grade, stage, chemotherapy, and radiotherapy, 6-month delta-BMI change remained an independent prognostic factor for DFS and OS (all p < 0.05): adjusted hazard ratios, ≥15 % delta-BMI loss (3.35 and 5.39), 7.5–14.9 % loss (2.35 and 4.19), 7.5–14.9 % gain (2.58 and 3.33), and ≥15.0 % gain (2.50 and 3.45) compared with <7.5 % loss. Similar findings were observed at a 1-year time point (p < 0.05). Baseline BMI was not associated with survival outcome (p > 0.05).

Conclusion

Our results demonstrated that endometrial cancer patients continued to gain weight after hysterectomy, and post-treatment weight change had bidirectional effects on survival outcome.
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Metadata
Title
Weight Change Pattern and Survival Outcome of Women with Endometrial Cancer
Authors
Koji Matsuo, MD, PhD
Aida Moeini, MD
Sigita S. Cahoon, MD
Hiroko Machida, MD
Marcia A. Ciccone, MD
Brendan H. Grubbs, MD
Laila I. Muderspach, MD
Publication date
01-09-2016
Publisher
Springer International Publishing
Published in
Annals of Surgical Oncology / Issue 9/2016
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-016-5237-9

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