Celik Engin, Kizildag Yirgin Inci, Goksever Celik Hale, Engin Gulgun, Sozen Hamdullah, Ak Naziye, Saip Pınar, Onder Semen, Topuz Samet, Salihoglu Mehmet Y
Department of Obstetrics and Gynecology, Health Sciences University Istanbul Kanuni Sultan Suleyman Training and Research Hospital, Istanbul, Turkey.
Department of Radiology, Istanbul University Institute of Oncology, Istanbul, Turkey.
J Obstet Gynaecol Res. 2021 Feb;47(2):560-569. doi: 10.1111/jog.14560. Epub 2020 Nov 16.
Endometrial cancer is the most common cancer of the female reproductive tract in the developed countries. There are many risk factors defined for the development of endometrial cancer, including obesity. We aimed to evaluate the significance of adiposity on the survival outcomes of the patients with endometrial cancer.
The patients diagnosed with endometrial cancer and underwent surgery between April 2009 and October 2017 were retrospectively reviewed. The visceral adipose tissue and subcutaneous adipose tissue volumes were measured at the level of umbilicus on single-slice magnetic resonance imaging. Visceral adiposity index was calculated. Patients were compared regarding their clinical, demographical, pathologic and survival characteristics. Patients divided into low visceral adiposity (≤0.265, group 1) and high visceral adiposity (>0.265, group 2).
A total of 186 patients were included in this retrospective study. There was no significant difference in terms of the demographical, clinical and tumor characteristics of the patients, except age, menopausal status, subcutaneous adipose tissue and visceral adipose tissue. Although no significant difference in progression-free survival and disease-specific survival was noted between groups (P = 0.181), more patients in group 2 died because of endometrial cancer as statistically significant (P = 0.024). Disease-specific survival showed a significant difference between groups according to the log-rank test.
Visceral adiposity tissue is a significant and reliable prognostic indicator for endometrial cancer prognosis. Women diagnosed with endometrial cancer should be informed about the deleterious effects of visceral adiposity on disease-specific survival.
子宫内膜癌是发达国家女性生殖道最常见的癌症。子宫内膜癌的发生有许多危险因素，包括肥胖。我们旨在评估肥胖对子宫内膜癌患者生存结局的意义。
回顾性分析2009年4月至2017年10月期间诊断为子宫内膜癌并接受手术的患者。在单层磁共振成像上于脐水平测量内脏脂肪组织和皮下脂肪组织体积。计算内脏肥胖指数。比较患者的临床、人口统计学、病理和生存特征。患者分为低内脏肥胖组（≤0.265，第1组）和高内脏肥胖组（>0.265，第2组）。
本回顾性研究共纳入186例患者。除年龄、绝经状态、皮下脂肪组织和内脏脂肪组织外，患者的人口统计学、临床和肿瘤特征无显著差异。虽然两组之间的无进展生存期和疾病特异性生存期无显著差异（P = 0.181），但第2组中因子宫内膜癌死亡的患者更多，具有统计学意义（P = 0.024）。根据对数秩检验，两组之间的疾病特异性生存期有显著差异。
内脏脂肪组织是子宫内膜癌预后的一个重要且可靠的预后指标。应告知诊断为子宫内膜癌的女性内脏肥胖对疾病特异性生存的有害影响。
