Body mass index and mortality in endometrial cancer: A systematic review and meta-analysis

Secord, Angeles Alvarez; Hasselblad, Vic; Gruenigen, Vivian E. von; Gehrig, Paola A.; Modesitt, Susan C.; Bae‐Jump, Victoria L.; Havrilesky, Laura J.

doi:10.1016/j.ygyno.2015.10.020

Cited by 126 publications

(97 citation statements)

References 39 publications

(85 reference statements)

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“…This is in agreement with recent National Health Interview Survey report that demonstrated higher proportion of poor and fair overall health status in AA women, while white women had higher scores in the very good and excellent categories [27]. Several investigators highlighted the important prognostic impact of comorbidity burden including obesity on survival endpoint of women with EC [17,[28][29][30]. The results of these studies support the theory that comorbidity burden may play a major role in cancer prognosis [31,32] particularly in patients with higher survival rates [33] such as women with early stage EC.…”

Section: Discussionsupporting

confidence: 89%

A Matched Analysis on the Prognostic Impact of Race on Survival Endpoints of Women with Early-Stage Endometrial Cancer

Feldman

Chaugle

Burmeister

et al. 2018

Gynecol Obstet Invest

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Objective: To compare survival endpoints between African American (AA) and non-AA (NAA) women with endometrial carcinoma (EC) stage I–II using a robust matching analysis. Methods and Materials: Patients were matched by stage, grade, adjuvant management (surveillance, vaginal brachytherapy or pelvic radiation treatment), age, and year of hysterectomy. Recurrence-free survival (RFS), disease-specific survival (DSS) and overall survival (OS) were calculated. Results: A total of 758 patients were included. Body mass index and Age-Adjusted Charlson comorbidity index was significantly higher in AA compared to NAA women. There were no significant differences between the AA and NAA groups in regard to 5-year RFS (94 vs. 93%), DSS (96 vs. 98%) or 5-year OS (90 vs. 92%). On multivariate analysis of survival endpoints for the entire study cohort, it was found that race (AA vs. NAA) was not a significant predictor of RFS, DSS, or OS. Grade 3 tumors and the presence of lymphovascular space invasion (LVSI) were the only 2 independent predictors of RFS and DSS, while age-adjusted Charlson comorbidity score, grade 3, stage II and the presence of LVSI were independent predictors of shorter OS. Conclusions: When matched based on the tumor stage, grade, adjuvant treatment, age, and year of surgery, our study suggests that there is no statistically significant difference in any survival endpoints between AA and NAA women with early-stage EC. Based on these data, disparities in outcome likely do not stem from uterine cancer-related causes. The increased comorbidity burden in AA women is likely a factor contributing to the racial disparity in endometrial cancer.

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Section: Discussionsupporting

confidence: 89%

A Matched Analysis on the Prognostic Impact of Race on Survival Endpoints of Women with Early-Stage Endometrial Cancer

Feldman

Chaugle

Burmeister

et al. 2018

Gynecol Obstet Invest

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“…The selection of limiting values for the numeric variables (2 cm for tumor diameter, 65 years for age, 30 kg/m 2 for BMI) was based on earlier reports. 6,11,22 The depth of myometrial invasion was unknown in 1 patient. Primary tumor diameter was defined as the largest dimension of the tumor.…”

Section: Methodsmentioning

confidence: 99%

L1 Cell Adhesion Molecule as a Predictor of Disease-Specific Survival and Patterns of Relapse in Endometrial Cancer

Pasanen

Tuomi²,

Isola³

et al. 2016

Int J Gynecol Cancer

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“…The mechanisms by which obesity promotes pancreatic cancer is not completely known; however, they likely involve obesity-associated inflammation, insulin resistance, increased infiltration of macrophages and immunosuppressive cells, and dysregulation of autophagy [128–130]. Obesity is also associated with the incidence and mortality of endometrial and ovarian cancer [131,132]. Obesity likely promotes endothelial cancer through increased insulin/IGF signaling, increased estrogens, chronic inflammation and increased leptin mediated activation of PI3k/Akt/mTOR signaling [133,134].…”

Section: Obesity and Cancermentioning

confidence: 99%

Obesity and cancer: inflammation bridges the two

Kolb

Sutterwala

Zhang

2016

Current Opinion in Pharmacology

304

228

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Obesity is a growing public health problem and affects 35% US adults. Obesity increases the risk of many cancer types and is associated with poor outcomes. Clinical management of cancer patients has been essentially the same between normal weight and obese individuals. Understanding causal mechanisms by which obesity drives cancer initiation and progression is essential for the development of novel precision therapy for obese cancer patients. One caveat is that various mechanisms have been proposed for different cancer types for their progression under obesity. Since obesity is known to have global impact on inflammation, here we will summarize recent literature and discuss the potential of inflammation being the common causal mechanism to promote cancer promotion across cancer types.

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Body mass index and mortality in endometrial cancer: A systematic review and meta-analysis

Abstract: Increased BMI is significantly associated with increased all-cause mortality in women with endometrial cancer, with the highest risk for those with a BMI≥40.

Cited by 126 publications

References 39 publications

A Matched Analysis on the Prognostic Impact of Race on Survival Endpoints of Women with Early-Stage Endometrial Cancer

A Matched Analysis on the Prognostic Impact of Race on Survival Endpoints of Women with Early-Stage Endometrial Cancer

L1 Cell Adhesion Molecule as a Predictor of Disease-Specific Survival and Patterns of Relapse in Endometrial Cancer

Obesity and cancer: inflammation bridges the two

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