Department of Obstetrics and Gynaecology, University Hospital Giessen and Marburg GmbH, Klinikstrasse 33, 35385 Giessen, Germany.
Arch Gynecol Obstet. 2012 Jun;285(6):1725-9. doi: 10.1007/s00404-012-2224-7. Epub 2012 Jan 19.
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.
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.
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/m(2)) 6 months after the diagnosis had the best prognosis, followed by patients with greater weight gain (>1 kg/m(2)) and those with moderate weight loss (≤ 1 kg/m(2)). 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.
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.
肥胖与子宫内膜癌的发生有关。目前尚不清楚它是否也与癌症复发有关。本分析评估了诊断为子宫内膜癌后随访期间体重变化对癌症复发的影响。
对 705 例子宫内膜癌患者的记录进行了回顾，以评估癌症诊断后随访期间的体重变化，并与无复发生存相关。
约三分之二的子宫内膜癌患者在诊断后体重或多或少有所增加。诊断后 6 个月体重适度增加（≤ 1 kg/m²）的患者预后最佳，其次是体重增加较多（>1 kg/m²）和体重适度减轻（≤ 1 kg/m²）的患者。即使将分析仅限于 18 个月后发生的复发，体重减轻与预后不良相关的情况仍然存在。
癌症诊断和治疗后的体重减轻可能是一个不利的预后因素。尽管无法区分有意和无意的体重减轻，但这些结果不支持对确诊的子宫内膜癌患者通过减轻体重来降低风险。然而，对于降低非癌症相关发病率和死亡率的风险可能是合理的。需要进行详细的前瞻性随机临床试验。
