肥胖患者 II 型子宫内膜癌的生存结局：定义 BMI 增加的预后影响。

Survival outcomes of obese patients in type II endometrial cancer: Defining the prognostic impact of increasing BMI.

机构信息

Department of Obstetrics and Gynecology, Division of Gynecology Oncology, The Ohio State University, College of Medicine, 320 W 10th Avenue, M210 Starling Loving, Columbus, OH 43210, United States.

Department of Obstetrics and Gynecology, Division of Gynecologic Specialties, University of California, Davis, 4860 Y Street, Suite 2500, Sacramento, CA 95817, United States.

出版信息

Gynecol Oncol. 2016 Mar;140(3):405-8. doi: 10.1016/j.ygyno.2016.01.020. Epub 2016 Jan 20.

DOI:10.1016/j.ygyno.2016.01.020

PMID:26801939

Abstract

OBJECTIVE

To investigate the role of obesity as a risk factor for type II endometrial cancer (EC), as well as the prognostic significance of increasing body mass index (BMI) on survival.

METHODS

A single institution retrospective analysis of 154 type II EC cases from 1987 to 2010 was conducted. Patients were categorized into cohorts by BMI (normal (<25), overweight (25-29.9), obese class I (30-34.9), and obese class II-III (≥35)). Descriptive, regression and ANOVA analyses were performed. Kaplan-Meier curves were compared with log rank tests.

RESULTS

The BMI distribution was 22.8% normal BMI; 24% overweight; 17.5% class I; and 35.7% class II-III. The median follow up was 41 months. The median progression-free survival (PFS) was 45.4, 36.0, 35.3 and 42.0 months and overall survival (OS) was 54.7, 44.7, 44.8 and 49.7 months, among the respective groups. There was no association between BMI and PFS (p=0.71), OS (p=0.72), or time to recurrence (p=0.71). There were no differences among the increasing BMI groups compared to normal weight women for the risk of death.

CONCLUSIONS

Our analysis did not reveal any differences in outcomes by BMI group. Our data reveals that obesity is highly prevalent in type II ECs, though obesity has not historically been described as a risk factor. While BMI as a single variable may not be prognostic for survival outcomes, the role of obesity as a risk factor for type II EC should be further investigated, given the increasing prevalence of obesity in type II ECs.

摘要

目的

探讨肥胖作为 II 型子宫内膜癌（EC）风险因素的作用，以及体重指数（BMI）增加对生存的预后意义。

方法

对 1987 年至 2010 年间的 154 例 II 型 EC 病例进行单机构回顾性分析。根据 BMI（正常（<25）、超重（25-29.9）、肥胖 I 级（30-34.9）和肥胖 II-III 级（≥35））将患者分为队列。进行描述性、回归和 ANOVA 分析。Kaplan-Meier 曲线与对数秩检验进行比较。

结果

BMI 分布为 22.8%正常 BMI；24%超重；17.5%肥胖 I 级；35.7%肥胖 II-III 级。中位随访时间为 41 个月。无进展生存期（PFS）的中位数分别为 45.4、36.0、35.3 和 42.0 个月，总生存期（OS）分别为 54.7、44.7、44.8 和 49.7 个月，分别在各组。BMI 与 PFS（p=0.71）、OS（p=0.72）或复发时间（p=0.71）无关。与体重正常的女性相比，BMI 逐渐增加的各组发生死亡的风险没有差异。