Department of Cancer Epidemiology and Prevention Research, Cancer Care Alberta, Alberta Health Services, Calgary, AB, Canada.
Department of Kinesiology, Faculty of Health and Human Sciences, University of North Carolina Greensboro, Greensboro, NC, USA.
J Natl Cancer Inst. 2022 Mar 8;114(3):409-418. doi: 10.1093/jnci/djab197.
Disease-free survival (DFS) and overall survival (OS) associations with anthropometric measures of obesity and changes in these exposures remain unknown among endometrial cancer survivors.
Endometrial cancer survivors diagnosed between 2002 and 2006 completed direct anthropometric measurements and self-reported lifetime weight history during in-person interviews approximately 4 months after diagnosis (peridiagnosis) and approximately 3 years after diagnosis (follow-up). Participants were followed-up until death or March 20, 2019. Cox proportional regression was used to estimate multivariable-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for body mass index (BMI), weight, waist circumference, and waist-hip ratio with DFS and OS. Statistical tests were 2-sided.
A total of 540 and 425 cancer survivors were assessed peridiagnosis and follow-up, respectively. During the median 14.2 years of follow-up (range = 0.3-16.5 years), 132 participants had a recurrence and/or died (DFS), with 111 deaths overall (OS). Reduced DFS was noted with greater recalled weight 1 year before diagnosis (HR = 1.88, 95% CI = 1.15 to 3.07), BMI 1 year before diagnosis (HR = 1.88, 95% CI = 1.09 to 3.22), and measured peridiagnosis BMI (HR = 2.04, 95% CI = 1.18 to 3.53). Measured peridiagnosis waist circumference of at least 88 cm was associated with decreased DFS (HR = 1.94, 95% CI = 1.24 to 3.03) and OS (HR = 1.90, 95% CI = 1.16 to 3.13). A twofold decrease in DFS and OS was associated with a BMI of at least 5% or weight change from 1 year before diagnosis to peridiagnosis. No associations were observed for the assessment during follow-up.
One-year before- and peridiagnosis anthropometric measures of obesity were associated with reduced survival among endometrial cancer survivors. Anthropometric changes from 1 year before to peridiagnosis may provide an important indication of future survival in this population.
肥胖的人体测量学指标（包括无病生存时间 [DFS] 和总生存时间 [OS]）与子宫内膜癌幸存者之间的关系尚不清楚。
2002 年至 2006 年间诊断为子宫内膜癌的幸存者在诊断后约 4 个月（围诊断期）和约 3 年后（随访期）进行了直接人体测量测量和自我报告的终生体重史。参与者随访至死亡或 2019 年 3 月 20 日。使用 Cox 比例风险回归来估计体重指数（BMI）、体重、腰围和腰臀比与 DFS 和 OS 的多变量调整后的风险比（HR）和 95%置信区间（CI）。统计检验为双侧。
分别有 540 名和 425 名癌症幸存者在围诊断期和随访期进行了评估。在中位数为 14.2 年的随访期间（范围=0.3-16.5 年），132 名参与者出现复发和/或死亡（DFS），总共有 111 人死亡（OS）。与围诊断期 BMI 测量值相比，诊断前 1 年的体重（HR=1.88，95%CI=1.15-3.07）、诊断前 1 年的 BMI（HR=1.88，95%CI=1.09-3.22）和体重（HR=1.88，95%CI=1.15-3.07）均与 DFS 降低有关。腰围至少为 88cm 的围诊断期腰围与 DFS（HR=1.94，95%CI=1.24-3.03）和 OS（HR=1.90，95%CI=1.16-3.13）降低有关。DFS 和 OS 降低两倍与 BMI 至少增加 5%或体重从诊断前 1 年到围诊断期的变化有关。在随访期间未观察到任何相关性。
在诊断前 1 年和围诊断期进行的肥胖人体测量学评估与子宫内膜癌幸存者的生存降低有关。从诊断前 1 年到围诊断期的体重变化可能为该人群的未来生存提供重要指示。
