Influence of body mass index on prognosis in gynecological malignancies
- Karsten MünstedtAffiliated withDepartment of Obstetrics and Gynecology, Clinic of the Universities Giessen and Marburg Email author
- , Mathias WagnerAffiliated withDepartment of Obstetrics and Gynecology, Clinic of the Universities Giessen and Marburg
- , Uwe KullmerAffiliated withDepartment of Obstetrics and Gynecology, Asklepios Clinic
- , Andreas HackethalAffiliated withDepartment of Obstetrics and Gynecology, Clinic of the Universities Giessen and Marburg
- , Folker E. FrankeAffiliated withInstitute of Pathology, Clinic of the Universities Giessen and Marburg
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To evaluate the effect of obesity on the presentation and course of disease in patients with gynecological cancers.
Records of patients with endometrial (n = 1180), cervical (n = 738), and ovarian cancer (n = 824) treated between 1986 and 2005 were reviewed. Body mass index (BMI) was analyzed in relation to tumor stage, tumor grading, and prognosis. Steroid hormone receptor status and growth fraction (MIB1; Ki-67-antigen) of tumors in relation to BMI were analyzed in subgroups with endometrial (n = 183) and advanced ovarian (n = 221) cancers. In the latter subgroup, tumor vascularization (CD31) and expression of bcl-2, c-erb-B2, fibronectin, and tumor markers (CA-125, CA15-3, CEA) were also evaluated. Statistical analyses included bivariate correlation, cross-tabulation, Kaplan-Meier-survival analyses, and multifactorial residual survival analyses.
Obese patients with endometrial carcinoma were significantly younger (p < 0.001) and their tumors were less advanced at diagnosis (p = 0.001) and were better differentiated (p = 0.010). In the subgroups, neither steroid hormone receptor status nor MIB1-determined growth fraction correlated with BMI. For both endometrial and cervical carcinomas, a high BMI influenced overall survival favorably (p endometrial = 0.004 and p cervical = 0.026). In ovarian cancer, there was a trend toward improved survival in more obese patients (p = 0.053). Immunohistochemistry revealed that c-erb-B2 expression was slightly lower in tumors of obese patients (r = −0.142; p = 0.039), but BMI did not influence any other factor.
Although obesity increases the incidence of cancer, a high BMI does not seem to adversely influence the prognosis in patients with the mentioned gynecological malignancies.
KeywordsBody mass index Endometrial cancer Cervical cancer Ovarian cancer Prognosis Tumor biology
- Influence of body mass index on prognosis in gynecological malignancies
Cancer Causes & Control
Volume 19, Issue 9 , pp 909-916
- Cover Date
- Print ISSN
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- Springer Netherlands
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- Body mass index
- Endometrial cancer
- Cervical cancer
- Ovarian cancer
- Tumor biology
- Industry Sectors
- Author Affiliations
- 1. Department of Obstetrics and Gynecology, Clinic of the Universities Giessen and Marburg, Klinikstrasse 32, 35385, Giessen, Germany
- 2. Department of Obstetrics and Gynecology, Asklepios Clinic, Lich, Germany
- 3. Institute of Pathology, Clinic of the Universities Giessen and Marburg, Giessen, Germany