Santana Beatriz Navarro, Soriano Jose Verdú, Arencibia Octavio, Petousis Stamatios, Margioula-Siarkou Chrysoula, González Daniel, Laseca Maria, Rave Andrés, Martínez Alicia Martín
Doctoral School, University of Las Palmas de Gran Canaria, 35001 Las Palmas de Gran Canaria, Spain.
Department of Gynecologic Oncology, Insular University Hospital of Las Palmas, 35016 Las Palmas de Gran Canaria, Spain.
Oncol Lett. 2023 Dec 5;27(2):44. doi: 10.3892/ol.2023.14177. eCollection 2024 Feb.
Despite the fact that obesity is the main risk factor for endometrial cancer, there is limited evidence regarding the effects of body weight change on overweight and obese women treated for early-stage endometrial can its impact on cancer outcomes. A retrospective cohort study was performed including all overweight and obese patients with early-stage type-I endometrial cancer that were treated at the Insular University Hospital of Las Palmas (Las Palmas de Gran Canaria, Spain) between January 2007 and December 2019. Body weight change at 12 months of treatment was evaluated, as well as its impact on cancer outcomes. Weight loss ≥5% was independently evaluated regarding its impact on survival. A total of 526 women were studied, of which 152 (28.90%) were overweight (BMI ≥25 and <30) and 374 (71.10%) were obese (BMI ≥30). The median follow-up was 76.17 months, during which time 77 (14.64%) women died. In the survivor group, body weight at initial diagnosis was 86.4±17.9 kg compared with 84.6±16.4 kg 1 year after treatment, which corresponded to a significant mean weight loss of 1.47 kg (P<0.001). However, in the group of non-survivors, body weight at initial diagnosis was 84.7±15.7 kg compared with 84.7±14.6 kg 1 year after treatment, which demonstrated a non-significant mean weight loss of 0.63 kg (P=0.180). When comparing between the patients who maintained or gained ≥5% weight and those who lost ≥5% weight, there were no significant differences taking into account the whole cohort and follow-up time; however, when adjusting for the period between 32 and 98 months, survival was significantly higher in those patients that lost ≥5% of their initial body weight (P=0.025; log-rank test). Based on the final univariate and cer and multivariate analyses, body weight change at 12 months was not indicated to be a factor significantly affecting overall survival; adjusted hazard ratio was 1.01 (95% CI 0.97-1.05, P=0.723). In conclusion, even if greater weight loss is observed in patients with endometrial cancer that survive the disease, no significant impact on survival outcomes is observed based on multivariate analysis.
尽管肥胖是子宫内膜癌的主要风险因素，但关于体重变化对超重和肥胖的早期子宫内膜癌患者治疗效果及其对癌症预后影响的证据有限。进行了一项回顾性队列研究，纳入了2007年1月至2019年12月在西班牙大加那利岛拉斯帕尔马斯岛大学医院接受治疗的所有超重和肥胖的I型早期子宫内膜癌患者。评估了治疗12个月时的体重变化及其对癌症预后的影响。独立评估体重减轻≥5%对生存的影响。共研究了526名女性，其中152名（28.90%）超重（BMI≥25且<30），374名（71.10%）肥胖（BMI≥30）。中位随访时间为76.17个月，在此期间77名（14.64%）女性死亡。在存活组中，初始诊断时体重为86.4±17.9kg，治疗1年后为84.6±16.4kg，平均体重显著减轻1.47kg（P<0.001）。然而，在非存活组中，初始诊断时体重为84.7±15.7kg，治疗1年后为84.7±14.6kg，平均体重减轻0.63kg，差异无统计学意义（P=0.180）。比较体重维持或增加≥5%的患者与体重减轻≥5%的患者，考虑整个队列和随访时间，差异无统计学意义；然而，调整32至98个月期间后发现，初始体重减轻≥5%的患者生存率显著更高（P=0.025；对数秩检验）。基于最终的单因素和多因素分析，12个月时的体重变化未显示为显著影响总生存的因素；调整后的风险比为1.01（95%CI 0.97-1.05，P=0.723）。总之，即使在子宫内膜癌存活患者中观察到更大程度的体重减轻，但多因素分析显示对生存结局无显著影响。
