Socioeconomic deprivation and survival in endometrial cancer: The effect of BMI

Donkers, Hannah; Bekkers, Ruud L.M.; Massuger, Leon F.A.G.; Galaal, Khadra

doi:10.1016/j.ygyno.2019.10.030

Cited by 18 publications

(22 citation statements)

References 21 publications

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“…This may be due to the fact that many previous studies have focused on all patients with EC, but this study only focused on EC patients with bone metastasis. Our univariable analysis also showed that age was not correlated with OS or CSS, which was not congruent with many previous studies including metastatic EC (3,14,15). Further researches are required to confirm our finding.…”

Section: Discussioncontrasting

confidence: 95%

Clinicopathological Characteristics and Prognosis in Endometrial Cancer With Bone Metastasis: A SEER-Based Study of 584 Women

Wang²,

Zhang³

et al. 2021

Front. Oncol.

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PurposeBone metastasis from endometrial cancer (EC) is rare and poorly described. The purpose of the present study was to investigate the correlation between the clinically accessible factors and survival time among EC patients with bone metastasis.Patients and MethodsWe retrospectively identified and reviewed EC patients with bone metastasis from 2010 to 2016, based on the Surveillance, Epidemiology and End Results (SEER) database. Univariable and multivariable Cox regressions were applied to evaluate the effects of clinical variables on survival. Kaplan–Meier plots were used to visually demonstrate the correlation between independent risk factors and survival.ResultsClinical data of 584 EC patients with bone metastasis from the SEER database were analyzed. EC patients with bone metastasis experienced extremely poor survival, with 1-year overall survival (OS) and cancer-specific survival (CSS) rates 33.8 and 35.8%, respectively. Variables associated with OS and CSS in the univariable analysis included race, tumor grade, tumor subtype, tumor size, lung, liver and brain metastases, surgery, radiotherapy, and chemotherapy. In the multivariable analysis, tumor grade, tumor subtype, liver and brain metastases, local surgery, and systemic chemotherapy remained independent risk factors for OS and CSS. However, local radiotherapy was an independent predictor of OS, not CSS.ConclusionsWe identified several factors affect the survival of EC patients with bone metastasis, which is useful for clinicians to assess patients’ outcomes. Our study supports surgery and radiotherapy of primary EC, and systemic chemotherapy for prolonging survival among EC patients with bone metastasis, which lays a solid foundation for defining optimal treatment strategy in this specific cohort.

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Section: Discussioncontrasting

confidence: 95%

Clinicopathological Characteristics and Prognosis in Endometrial Cancer With Bone Metastasis: A SEER-Based Study of 584 Women

Wang²,

Zhang³

et al. 2021

Front. Oncol.

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“…This study was unable to adjust for important prognostic factors like age, BMI and comorbidities, however, that may explain some of the observed associations. A recent study by Donkers and colleagues, involving 688 women with endometrial cancer, found no social gradient in survival outcomes after adjusting for confounding factors 27 . Interestingly, women from more affluent communities had a higher rate of recurrence than women from deprived communities, but this did not translate into an increase in cancer‐specific deaths.…”

Section: Discussionmentioning

confidence: 94%

“…A recent study by Donkers and colleagues, involving 688 women with endometrial cancer, found no social gradient in survival outcomes after adjusting for confounding factors. 27 Interestingly, women from more affluent communities had a higher rate of recurrence than women from deprived communities, but this did not translate into an increase in cancer-specific deaths. The least deprived social group was under-represented, comprising just 5% of their total cohort compared with 28% of our cohort.…”

Section: Discussionmentioning

confidence: 97%

“…Few studies have examined the role of SES on endometrial cancer survival outcomes, 13 and only three have been based in the UK. 14,15,27 Gildea and colleagues found no association between 30-day postoperative mortality and income deprivation, but failed to assess long-term outcomes. 15 The National Cancer Intelligence Network reported an association between income deprivation and endometrial cancer survival in England, with women from socially deprived backgrounds having a higher overall mortality compared with women from less deprived backgrounds.…”

Section: Discussionmentioning

confidence: 99%

“…Few studies have examined the role of SES on endometrial cancer survival outcomes, 13 and only three have been based in the UK 14,15,27 . Gildea and colleagues found no association between 30‐day postoperative mortality and income deprivation, but failed to assess long‐term outcomes 15 .…”

Section: Discussionmentioning

confidence: 99%

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Impact of socio‐economic deprivation on endometrial cancer survival in the North West of England: a prospective database analysis

Njoku

Barr

Hotchkies

et al. 2021

BJOG

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Objective To assess the impact of socio-economic deprivation on endometrial cancer survival.Design Single-centre prospective database study.Setting North West England.Population Women with endometrial cancer treated between 2010 and 2015.Methods Areal-level socio-economic status, using the English indices of multiple deprivation from residential postcodes, was analysed in relation to survival using Kaplan-Meier estimation and multivariable Cox regression.Main outcome measures Overall survival, cancer-specific survival and patterns and rates of recurrence.Conclusions We found that socio-economically deprived women with endometrial cancer were more likely to develop fatal recurrence. Larger studies are needed to confirm these findings and to identify modifiable contributing factors.

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Socioeconomic disparities in endometrial cancer survival in Germany: a survival analysis using population-based cancer registry data

Bedir

Abera

Vordermark

et al. 2022

J Cancer Res Clin Oncol

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Purpose Area-based socioeconomic deprivation has been established as an important indicator of health and a potential predictor of survival. In this study, we aimed to measure the effect of socioeconomic inequality on endometrial cancer survival. Methods Population-based data on patients diagnosed with endometrial cancer between 2004 and 2014 were obtained from the German Centre for Cancer Registry Data. Socioeconomic inequality was defined by the German Index of Socioeconomic Deprivation. We investigated the association of deprivation and overall survival through Kaplan–Meier curves and Cox proportional regression models. Results A total of 21,602 women, with a mean age of 67.8 years, were included in our analysis. The observed 5-year overall survival time for endometrial cancer patients living in the most affluent districts (first quintile) was 78.6%. The overall survival rate decreased as the level of deprivation increased (77.2%, 73.9%, 76.1%, 74.7%, for patients in the second, third, fourth, and fifth quintile (most deprived patients), respectively). Cox regression models showed stage I patients living in the most deprived districts to have a higher hazard of overall mortality when compared to the cases living in the most affluent districts [Hazard ratio: 1.20; 95% Confidence interval (0.99–1.47)] after adjusting for age, tumor characteristics, and treatment. Conclusion Our results indicate differences in endometrial cancer survival according to socioeconomic deprivation among stage I patients. Considering data limitations, future studies with access to individual-level patient information should be conducted to examine the underlying causes for the observed disparity in cancer survival.

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Socioeconomic deprivation and survival in endometrial cancer: The effect of BMI

Cited by 18 publications

References 21 publications

Clinicopathological Characteristics and Prognosis in Endometrial Cancer With Bone Metastasis: A SEER-Based Study of 584 Women

Clinicopathological Characteristics and Prognosis in Endometrial Cancer With Bone Metastasis: A SEER-Based Study of 584 Women

Impact of socio‐economic deprivation on endometrial cancer survival in the North West of England: a prospective database analysis

Socioeconomic disparities in endometrial cancer survival in Germany: a survival analysis using population-based cancer registry data

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