Effect of BMI change on recurrence risk in patients with endometrial cancer

Abstract

ObjectiveOur study aimed to explore the effect of body mass index (BMI) change on cancer recurrence risk during the routine surveillance of endometrial cancer patients.MethodsData on patients with endometrial adenocarcinoma that had a staging procedure and continued follow-up was retrospectively collected. We compared patients’ BMI at time of surgery and during the last clinic follow-up. Univariate and multivariate analyses were performed to examine the effect of predictors on BMI change and the risk of recurrence.ResultsA total of 211 patients were included in the final analysis. The majority of patients had stage I disease (n=176, 89%) and endometrioid histology (n=178, 86%). Median follow-up time was 53.4 (standard deviation (SD) 40) months. The mean BMI was 30.4 kg/m2 (interquartile range (IQR) 25–34) at surgery compared with 30.9 kg/m2 (IQR 26–36) at last follow-up (p<0.001). The BMI increase was most pronounced in patients with endometroid histology that recurred, 31.6 (IQR 24–35) kg/m2at surgery compared with 33.5 (IQR 27–36) kg/m2at last follow-up (p=0.016). On multivariate analysis, age and BMI change were the only predictors that were significantly associated with the risk of recurrence (overall response (OR 1.07 (0.99–1.14), p=0.05, OR 1.37 (1.12–1.67), p=0.002, respectively).ConclusionPatients with endometroid endometrial cancer that had an increase in BMI during follow-up were at an increased risk for cancer recurrence compared with patients that did not change or had a decrease in BMI.

MLH1 Promoter Methylation Could Be the Second Hit in Lynch Syndrome Carcinogenesis

“…Interestingly, MLH1 somatic hypermethylation was observed in concomitance with germline MLH1 pathogenetic variants in CRC (16% of cases), in agreement with data reported by Moreira et al [17], and more frequently in EC (40% of cases). The more common involvement of MLH1 hypermethylation in EC with respect to CRC is highlighted in this work for the first time, and it is supported with evidence obtained from sporadic EC analyses [25,26]. In fact, as described by Borrego et al, in endometrial cancer, which is a hormone-sensitive tissue, non-genetic factors, such as body mass index and hormonal conditions, may play a role in the instauration of somatic MLH1 methylation [25].…”