Abstract
Objectives
Obesity is associated with the incidence of endometrial cancer. At present it is unclear whether it is also associated with cancer recurrence. This analysis evaluated the consequences of weight changes after diagnosis of endometrial cancer during the follow-up.
Methods
Records of patients with endometrial cancer (n = 705) were reviewed for body weight after the diagnosis of cancer during the follow-up and related to recurrence-free survival.
Results
About two-thirds of all endometrial patients gained more or less weight after the diagnosis of endometrial cancer. Patients with moderate weight gain (≤1 kg/m2) 6 months after the diagnosis had the best prognosis, followed by patients with greater weight gain (>1 kg/m2) and those with moderate weight loss (≤1 kg/m2). The fact that weight loss was associated with poor prognosis also persisted when the analysis was restricted to recurrences which occurred more than 18 months later.
Conclusions
Weight loss after the diagnosis and treatment of cancer may be an adverse prognostic factor. Although it was impossible to distinguish between intentional and non-intentional weight loss, these results argue against weight loss for risk reduction in patients with confirmed endometrial cancer. However, it may be reasonable regarding the risk reduction of non-cancer related morbidity and mortality. Detailed, prospective randomised trials are warranted.
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References
Ogden CL, Carroll MD, Curtin LR, McDowell MA, Tabak CJ, Flegal KM (2006) Prevalence of overweight and obesity in the United States, 1999–2004. JAMA 295:1549–1555
Haenle MM, Brockmann SO, Kron M et al (2006) Overweight, physical activity, tobacco and alcohol consumption in a cross-sectional random sample of German adults. BMC Public Health 6:233
Calle EE, Thun MJ (2004) Obesity and cancer. Oncogene 23:6365–6378
Bray F, Dos Santos Silva I, Moller H, Weiderpass E (2005) Endometrial cancer incidence trends in Europe: underlying determinants and prospects for prevention. Cancer Epidemiol Biomarkers Prev 14:1132–1142
Erkanli S, Kayaselcuk F, Bagis T, Kuscu E (2006) Impact of morbid obesity in surgical management of endometrial cancer: surgical morbidity, clinical and pathological aspects. Eur J Gynaecol Oncol 27:401–404
Everett E, Tamimi H, Greer B et al (2003) The effect of body mass index on clinical/pathologic features, surgical morbidity, and outcome in patients with endometrial cancer. Gynecol Oncol 90:150–157
McCourt CK, Mutch DG, Gibb RK et al (2007) Body mass index: relationship to clinical, pathologic and features of microsatellite instability in endometrial cancer. Gynecol Oncol 104:535–539
Temkin SM, Pezzullo JC, Hellmann M, Lee YC, Abulafia O (2007) Is body mass index an independent risk factor of survival among patients with endometrial cancer? Am J Clin Oncol 30:8–14
Münstedt K, Wagner M, Kullmer U, Hackethal A, Franke FE (2008) Influence of body mass index on prognosis in gynecological malignancies. Cancer Causes Control 19:909–916
McTiernan A, Irwin M, Vongruenigen V (2010) Weight, physical activity, diet, and prognosis in breast and gynecologic cancers. J Clin Oncol 28:4074–4080
Vahrson H (1991) Die Strahlentherapie des Korpuskarzinoms. In: Künzel W, Kirschbaum M (eds) Giessener Gynäkologische Fortbildung 1991. Springer, Berlin, pp 163–179
Van Cutsem E, Arends J (2005) The causes and consequences of cancer-associated malnutrition. Eur J Oncol Nurs 9(Suppl 2):S51–S63
von Gruenigen VE, Gibbons HE, Kavanagh MB, Janata JW, Lerner E, Courneya KS (2009) A randomized trial of a lifestyle intervention in obese endometrial cancer survivors: quality of life outcomes and mediators of behavior change. Health Qual Life Outcomes 7:17
Chen X, Lu W, Zheng W et al (2010) Obesity and weight change in relation to breast cancer survival. Breast Cancer Res Treat 122:823–833
Caan BJ, Kwan ML, Hartzell G et al (2008) Pre-diagnosis body mass index, post-diagnosis weight change, and prognosis among women with early stage breast cancer. Cancer Causes Control 19:1319–1328
Thivat E, Thérondel S, Lapirot O et al (2010) Weight change during chemotherapy changes the prognosis in non metastatic breast cancer for the worse. BMC Cancer 10:648
Münstedt K, von Georgi R, Franke FE (2010) Effect of obesity on survival in epithelial ovarian cancer. Cancer 109:811–812
Alici S, Kaya S, Izmirli M (2006) Analysis of survival factors in patients with advanced-stage gastric adenocarcinoma. Med Sci Monit 12: CR221–CR229
Lecleire S, Di Fiore F, Antonietti M et al (2006) Undernutrition is predictive of early mortality after palliative self-expanding metal stent insertion in patients with inoperable or recurrent esophageal cancer. Gastrointest Endosc 64:479–484
Parker AS, Lohse CM, Cheville JC, Thiel DD, Leibovich BC, Blute ML (2006) Greater body mass index is associated with better pathologic features and improved outcome among patients treated surgically for clear cell renal cell carcinoma. Urology 68:741–746
von Gruenigen VE, Tian C, Frasure H, Waggoner S, Keys H, Barakat RR (2006) Treatment effects, disease recurrence, and survival in obese women with early endometrial carcinoma: a Gynecologic Oncology Group study. Cancer 107:2786–2791
Acknowledgments
The authors thank Dr. Philipp Teichfischer, Magdeburg, Germany, for his critical discussion and suggestions for this paper.
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The authors declare that there are no conflicts of interest.
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El-Safadi, S., Sauerbier, A., Hackethal, A. et al. Body weight changes after the diagnosis of endometrial cancer and their influences on disease-related prognosis. Arch Gynecol Obstet 285, 1725–1729 (2012). https://doi.org/10.1007/s00404-012-2224-7
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DOI: https://doi.org/10.1007/s00404-012-2224-7