Department of Gynecology and Obstetrics, Hannover Medical School, Hannover, Germany
Department of Gynecology and Obstetrics, Hannover Medical School, Hannover, Germany.
Int J Gynecol Cancer. 2020 Jul;30(7):920-926. doi: 10.1136/ijgc-2019-001187. Epub 2020 May 28.
Obesity is associated with worse survival and an increased risk of relapse in several malignancies. The influence of obesity on vulvar cancer recurrence has not been previously described. The primary objective of this study was to evaluate the association between obesity and tumor recurrence in patients with vulvar cancer.
This is an analysis of the AGO-CaRE-1 study. Patients diagnosed with squamous cell vulvar cancer (stage IB and higher), treated in 29 cancer centers between January 1998 and December 2008, were registered in a centralized database. The cohort was divided into two gropus depending on the body mass index (BMI) (<30 vs ≥30 kg/m²). Descriptive statistics, survival analyses, and multivariate Cox regression analyses were performed in order to evaluate the association between obesity and progression-free and overall survival.
In 849 (52.4%) of 1618 patients in the database, the BMI was documented. Patients were grouped according to their BMI (<30 vs ≥30 kg/m²). There were 621 patients with a BMI <30 kg/m² and 228 patients with a BMI ≥30 kg/m². Besides age, there was no difference in baseline variables (tumor diameter, depth of infiltration, tumor stage, nodal metastasis, tumor grade). Treatment variables (R0 resection, chemotherapy, radiotherapy, continuation of adjuvant therapy) did not differ between groups. However, patients with BMI ≥30 kg/m² underwent radical vulvectomy more often (61.1% vs 51.8%, p=0.04). During follow-up there was a higher recurrence rate in the group with BMI ≥30 kg/m² (43.4% vs 28.3%, p<0.01) due to an increased rate of local recurrences (33.3% vs 18.5%, p<0.01). There was a significantly shorter time to recurrence in obese patients on univariate analysis (BMI ≥30 kg/m² vs <30 kg/m²: 43.8 months (95% CI 23.3 to 64.3) vs 102.3 months (95% CI 72.6 to 131.9), p=0.001) and on multivariate Cox regression analysis (HR 1.94 (95% CI 1.4 to 2.8), p<0.001).
In this study a BMI ≥30 kg/m² was associated with a shorter time to recurrence in patients with vulvar cancer and this was mainly attributed to a higher risk of local recurrence.
肥胖与多种恶性肿瘤的生存预后较差和复发风险增加有关。肥胖对外阴癌复发的影响尚未被描述。本研究的主要目的是评估肥胖与外阴癌患者肿瘤复发之间的关系。
这是一项 AGO-CaRE-1 研究的分析。1998 年 1 月至 2008 年 12 月期间，在 29 家癌症中心诊断为鳞状细胞外阴癌（IB 期及以上）的患者被登记在一个集中的数据库中。根据体重指数（BMI）（<30 与≥30 kg/m²）将队列分为两组。为了评估肥胖与无进展生存期和总生存期之间的关系，进行了描述性统计、生存分析和多变量 Cox 回归分析。
在数据库中 1618 名患者中的 849 名（52.4%）记录了 BMI。根据 BMI 将患者分为两组（<30 与≥30 kg/m²）。621 名患者 BMI<30 kg/m²，228 名患者 BMI≥30 kg/m²。除年龄外，基线变量（肿瘤直径、浸润深度、肿瘤分期、淋巴结转移、肿瘤分级）无差异。治疗变量（R0 切除、化疗、放疗、辅助治疗的延续）在两组之间没有差异。然而，BMI≥30 kg/m²的患者更常接受根治性外阴切除术（61.1%比 51.8%，p=0.04）。在随访期间，BMI≥30 kg/m²组的复发率更高（43.4%比 28.3%，p<0.01），这是由于局部复发率增加（33.3%比 18.5%，p<0.01）。单因素分析显示，肥胖患者的复发时间明显缩短（BMI≥30 kg/m²与<30 kg/m²：43.8 个月（95%CI 23.3 至 64.3）比 102.3 个月（95%CI 72.6 至 131.9），p=0.001），多因素 Cox 回归分析也显示（HR 1.94（95%CI 1.4 至 2.8），p<0.001）。
在这项研究中，BMI≥30 kg/m² 与外阴癌患者的复发时间更短相关，这主要归因于局部复发风险增加。
