The effect of visceral obesity on clinicopathological features in patients with endometrial cancer: a retrospective analysis of 200 Chinese patients

Ye, Shuang; Wen, Hao; Jiang, Zhen; Wu, Xiaohua

doi:10.1186/s12885-016-2230-4

Cited by 20 publications

(18 citation statements)

References 28 publications

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“…Increasing VAV% was significantly associated with high age in our cohort. Similar findings were reported by Ye et al [ 22 ], and the finding is in line with previous literature reporting gradual redistribution of fat to the visceral compartment with increasing age in healthy individuals [ 37 ]. Advanced age is known to be an unfavorable prognostic factor in EC [ 38 ].…”

Section: Discussionsupporting

confidence: 93%

“…To our knowledge, this is the first study of endometrial cancer presenting CT-based volumetric quantification of the abdominal fat compartments and estimates of liver density. Two previous CT studies on 122 [ 21 ] and 200 [ 22 ] EC patients, in which total, visceral and subcutaneous fat tissue areas were segmented on a single slice at the umbilical level, also showed positive correlations between BMI and total (r=0.87/0.67), subcutaneous (r=0.86/0.61) and visceral (r=0.75/0.43) fat areas (r=Pearson correlation coefficients for the two studies, respectively; all p-values <0.001). In our cohort, all the CT-derived obesity markers except VAV% were associated with low-grade endometrioid tumor subtype, which is clinically characterized by less aggressive disease.…”

Section: Discussionmentioning

confidence: 99%

“…Only a few studies have previously explored the visceral and subcutaneous fat distribution in relation to clinicopathological characteristics in EC [ 21 , 22 ]. One study suggested an association between a high proportion of visceral fat and aggressive clinical features, including lymph node metastasis and extrauterine disease [ 22 ]. However, none of these studies reported volumetric estimates of the abdominal fat compartments, nor included patient survival data.…”

Section: Introductionmentioning

confidence: 99%

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High visceral fat percentage is associated with poor outcome in endometrial cancer

et al. 2017

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Despite evidence of increased endometrial cancer (EC) risk in obese women, the impact of obesity on clinical and histological phenotype is poorly understood. This study explored abdominal fat volumes and fat distribution quantified by computed tomography (CT), in relation to tumor characteristics and outcome. 227 EC patients with preoperative abdominal CT scans were included. Total abdominal fat volume (TAV), subcutaneous abdominal fat volume (SAV) and visceral abdominal fat volume (VAV) were quantified, and visceral fat percentage calculated (VAV%=[VAV/TAV]x100). Waist circumference (WC) and liver density (LD) were measured, and body mass index (BMI) calculated. Data for estrogen, progesterone and androgen receptor (ERα/PR/AR) expression by immunohistochemistry were available for 149 tumors, and global gene expression data for 105 tumors. High BMI, TAV, SAV, VAV and WC, and low LD, were associated with low grade endometrioid tumors and PR and AR positivity (all p≤0.03). High VAV% was associated with high age (p<0.001), aneuploidy (p=0.01) and independently predicted reduced disease-specific survival (HR 1.05, 95% CI 1.00-1.11, p=0.041). Tumors from patients with low VAV% showed enrichment of gene sets related to immune activation and inflammation. In conclusion, high VAV% independently predicts reduced EC survival. Tumors arising in patients with low VAV% show enrichment of immune and inflammation related gene sets, suggesting that the global metabolic setting may be important for tumor immune response.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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High visceral fat percentage is associated with poor outcome in endometrial cancer

et al. 2017

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“…Visceral fat tissue is considered to play a greater role in carcinogenesis. Because the visceral part of total fat tissue is thought to be more pro‐inflammatory and pro‐tumorigenic due to the increased production of cytokines and growth factors, promoting carcinogenesis 23 . Alterations in adipokine secretion, hyperinsulinemia and subsequent stimulation of insulin‐like growth factor‐1 axis create a pro‐tumorigenic environment 24 …”

Section: Discussionmentioning

confidence: 99%

Does visceral adiposity have an effect on the survival outcomes of the patients with endometrial cancer?

Engin

Yırgın

Çelik

et al. 2020

J of Obstet and Gynaecol

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Aim Endometrial cancer is the most common cancer of the female reproductive tract in the developed countries. There are many risk factors defined for the development of endometrial cancer, including obesity. We aimed to evaluate the significance of adiposity on the survival outcomes of the patients with endometrial cancer. Methods The patients diagnosed with endometrial cancer and underwent surgery between April 2009 and October 2017 were retrospectively reviewed. The visceral adipose tissue and subcutaneous adipose tissue volumes were measured at the level of umbilicus on single‐slice magnetic resonance imaging. Visceral adiposity index was calculated. Patients were compared regarding their clinical, demographical, pathologic and survival characteristics. Patients divided into low visceral adiposity (≤0.265, group 1) and high visceral adiposity (>0.265, group 2). Results A total of 186 patients were included in this retrospective study. There was no significant difference in terms of the demographical, clinical and tumor characteristics of the patients, except age, menopausal status, subcutaneous adipose tissue and visceral adipose tissue. Although no significant difference in progression‐free survival and disease‐specific survival was noted between groups (P = 0.181), more patients in group 2 died because of endometrial cancer as statistically significant (P = 0.024). Disease‐specific survival showed a significant difference between groups according to the log‐rank test. Conclusion Visceral adiposity tissue is a significant and reliable prognostic indicator for endometrial cancer prognosis. Women diagnosed with endometrial cancer should be informed about the deleterious effects of visceral adiposity on disease‐specific survival.

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“…In a recent large-scale study of 4,010 cancer patients in good general condition, with distant metastases, median OS was twice as high in obese patients as in normal weight patients (8). However, there are also reports stating that there is no beneficial effect of obesity on metastatic neoplastic disease (9)(10)(11).…”

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confidence: 99%

Influence of Obesity on the Course of Malignant Neoplastic Disease in Patients After Pulmonary Metastasectomy

Rzechonek

Błasiak

Pniewski³

et al. 2018

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Abstract. Background (82.1±83.5 months vs. 43.0±44.4, p<0.01 and 110.7±81.3 months vs. 69.9±52.9 p<0.005, respectively). Survival after pulmonary metastasectomy was 27.2±25.6 months and was longer in obese and overweight patients than in normal weight patients (20.2±18.4 months vs. 29.4±26.5, p<0.05). Conclusion: Being obese or overweight is a favorable prognostic factor in patients after surgical resection of lung metastases of different malignancies.With the increasing epidemic of obesity in the world, the incidence of malignancies related to obesity also increases (1). Obesity-related cancers include breast cancer in postmenopausal women, colon cancer, cancer of the lower esophagus, gastric cancer, liver cancer, gall bladder cancer, pancreatic cancer, uterine cancer, ovarian cancer and renal cancer (2). Obesity is also associated with increased risk of metastases, including lung metastases, in some cancers (3).In the course of some malignancies a paradoxical phenomenon has been observed, indicating that obesity may be an oncogenic factor and -at the same time -may constitute a favorable prognostic factor (4, 5). The dual and opposite influence of obesity on the course of the same disease has been called the obesity paradox and has been described in some chronic diseases, including cardiovascular (6) and cerebrovascular diseases (7). These paradoxical effects of obesity may occur also in patients with metastases, including patients with malignancies not related to obesity. In a recent large-scale study of 4,010 cancer patients in good general condition, with distant metastases, median OS was twice as high in obese patients as in normal weight patients (8). However, there are also reports stating that there is no beneficial effect of obesity on metastatic neoplastic disease (9-11).The problem of the influence of obesity on the course of metastatic malignancies has not yet been unequivocally explained. Especially, there are no studies on the influence of obesity on survival of patients with operable lung metastases. Therefore, this study was undertaken to evaluate the long-term outcome of surgical treatment of obese and non-obese patients who after resection of primary neoplasm had lung metastases removed. Materials and MethodsData from 99 patients who had a resection of lung metastasis from different primary malignancies between 2001 and 2016 were analyzed. The study was retrospective, and the condition for including patients in the study was access to anesthesia documentation containing body weight and height prior to performing pulmonary metastasectomy. Analysis was performed in the groups depending on body mass index (BMI). Underweight was diagnosed when the BMI 197

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The effect of visceral obesity on clinicopathological features in patients with endometrial cancer: a retrospective analysis of 200 Chinese patients

Cited by 20 publications

References 28 publications

High visceral fat percentage is associated with poor outcome in endometrial cancer

High visceral fat percentage is associated with poor outcome in endometrial cancer

Does visceral adiposity have an effect on the survival outcomes of the patients with endometrial cancer?

Influence of Obesity on the Course of Malignant Neoplastic Disease in Patients After Pulmonary Metastasectomy

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