Association of obesity with survival in patients with endometrial cancer

Arsdale, Anne Van; Miller, Devin; Kuo, D.Y.S.; Isani, Sara; Sanchez, Lauren; Nevadunsky, Nicole S.

doi:10.1016/j.ygyno.2019.03.258

Cited by 20 publications

(31 citation statements)

References 14 publications

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“…60 Bjorge et al, 38 Calle et al 66 and Felix et al 71 91 also reported improved endometrial cancer-specific survival among endometrial cancer survivors with Class II (35-39.9 kg/m 2 ) obesity compared to normal weight (18.5-24.9 kg/m 2 ) survivors. 91 However, when stratified by endometrial cancer type, this association was only observed among women living with Type II endometrial cancer. 91 Nine additional studies that assessed the association between pre/at-diagnosis BMI and endometrial cancer-specific survival failed to observe a statistically significant relationship.…”

Section: Endometrial Cancer-specific Survivalmentioning

confidence: 97%

“…Forty-five 5,38,41,42,55, of these articles provided estimates for obesity, sixteen of which were included in a systematic review and metaanalysis that summarizes the association between BMI and survival in articles published prior to June 2013. 99 A total of thirty 5,38,[40][41][42]55,70,71,[75][76][77][78][79][80]84,88,90,91,94,95,[100][101][102][103][104][105][106][107][108][109] articles reported estimates for hyperglycemia, glucose levels or diabetes and recurrence or survival outcomes. There were eighteen 38,40,41,55,63,70,75,77,80,84,88,91,…”

Section: Aim and Objectivesmentioning

confidence: 99%

“…38,56,57 A summary of the literature that reports estimates of the associations for metabolic syndrome or more than one metabolic syndrome component and endometrial cancer recurrence or survival outcomes is presented in Table 2. Most of this literature was conducted as retrospective analyses of large prospective cohorts or databases, 38,40,55,70,77,79,94,95,101,109 twelve were retrospective cohorts derived from hospital medical records 41,56,57,63,75,76,78,80,84,88,90,91 and three studies were conducted prospectively. 5,42,71 Of note, while the language used to describe survival outcomes in the literature differed by study, all statistical estimates are presented in terms of recurrence or mortality events.…”

Section: Aim and Objectivesmentioning

confidence: 99%

“…The majority of studies that examined the association between obesity and endometrial cancer-specific survival 5,38,42,55,59,60,[64][65][66]71,75,77,79,84,85,88,89,91 59 Moreover, the five-year and ten-year endometrial cancer-specific survival decreased with greater pre-diagnosis BMI in the NIH-AARP Study (five-year: p-trend =0.04, ten-year: p-trend =0.02). 60 Bjorge et al, 38 Calle et al 66 and Felix et al 71 91 also reported improved endometrial cancer-specific survival among endometrial cancer survivors with Class II (35-39.9 kg/m 2 ) obesity compared to normal weight (18.5-24.9 kg/m 2 ) survivors. 91 However, when stratified by endometrial cancer type, this association was only observed among women living with Type II endometrial cancer.…”

Section: Endometrial Cancer-specific Survivalmentioning

confidence: 99%

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Prospective cohort study of metabolic syndrome and endometrial cancer survival

Kokts-Porietis

McNeil

Nelson

et al. 2020

Gynecologic Oncology

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Background: Metabolic syndrome has been previously associated with increased endometrial cancer risk, but the relationship with metabolic syndrome and endometrial cancer survival remains unclear. Objectives: To determine the associations between metabolic syndrome using the harmonized criteria with disease-free survival, overall survival, endometrial cancer-specific survival and time to recurrence among endometrial cancer survivors. Second, to determine the association between the number of metabolic syndrome components as well as each individual metabolic syndrome component with these prognostic outcomes. Methods: A prospective cohort of 540 endometrial cancer survivors diagnosed between 2002 and 2006 participated in the Alberta Endometrial Cancer Cohort and were followed until death or March 20, 2019. Baseline in-person interviews, direct anthropometric measurements and fasting blood samples were used to assess metabolic syndrome. Recurrence and survival data were obtained via medical chart abstraction and vital status updates. Results: Compared to endometrial cancer survivors without metabolic syndrome, survivors with metabolic syndrome had worse overall survival when assessed with the harmonized criteria. Of the individual metabolic syndrome components, only waist circumference was associated with recurrence and survival outcomes. Lifetime recreational physical activity prior to diagnosis was observed to modify the associations between metabolic syndrome and its components with overall survival and disease-free survival. Conclusion: The metabolic syndrome, especially waist circumference, was associated with worse overall and disease-free survival among endometrial cancer survivors. Future research should aim to confirm these results and improve our understanding of the role lifestyle factors iii such as physical activity have in the association between metabolic syndrome and endometrial cancer survivors' prognosis. iv Preface Chapter Four includes the main manuscript from this thesis which addresses the association between metabolic syndrome and its components defined by harmonized criteria with disease-free survival, overall survival, endometrial cancer-specific survival and recurrence among endometrial cancer survivors from the Alberta Endometrial Cancer Cohort Study. For this manuscript Renee Kokts-Porietis led the formal analysis and interpretation of data, as well as drafting, writing, reviewing and editing of the manuscript. All authors were involved in conceptualization and provided critical review of this manuscript. Kerry Courneya, Linda Cook and Christine Friedenreich were involved in the funding acquisition, methodology, investigation and project administration of the larger project. Finally, Jessica McNeil, Gregg Nelson and Christine Friedenreich provided supervision and guidance to Renee Kokts-Porietis at each stage of the project.

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Section: Endometrial Cancer-specific Survivalmentioning

confidence: 97%

Section: Aim and Objectivesmentioning

confidence: 99%

Section: Aim and Objectivesmentioning

confidence: 99%

Section: Endometrial Cancer-specific Survivalmentioning

confidence: 99%

See 2 more Smart Citations

Prospective cohort study of metabolic syndrome and endometrial cancer survival

Kokts-Porietis

McNeil

Nelson

et al. 2020

Gynecologic Oncology

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“…The latest estimates indicated that there were 61,880 new cases and 12,160 EC-related deaths in 2019 in the USA (1). Obesity, hypertension and diabetes are the major risk factors for the development of EC in developed nations (2,3). Furthermore, Lynch syndrome is known to lead to the development of EC (4,5).…”

Section: Introductionmentioning

confidence: 99%

Immune disorder in endometrial cancer: Immunosuppressive microenvironment, mechanisms of immune evasion and immunotherapy (Review)

et al. 2020

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Immunotherapy is an emerging clinical approach that has gained traction over the past decade as a novel treatment option for lung cancer and melanoma. Notably, researchers have made marked improvements in the treatment of endometrial cancer (EC), and potential immune responses have been identified in patients with EC, thereby offering the possibility of exploring immunotherapy for EC. Nevertheless, various needs remain unmet, and immunotherapy applications in EC have yielded limited success, as only a minority of patients exhibited a clinical response. Therefore, further understanding of immune dysfunction associated with EC is still required. The present review describes recent findings regarding the immunosuppressive microenvironment of EC, with emphasis on immune evasion mechanisms and immunotherapy in EC.

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