Cancer Causes & Control

, Volume 19, Issue 9, pp 909–916

Influence of body mass index on prognosis in gynecological malignancies

  • Karsten Münstedt
  • Mathias Wagner
  • Uwe Kullmer
  • Andreas Hackethal
  • Folker E. Franke
Original Paper

DOI: 10.1007/s10552-008-9152-7

Cite this article as:
Münstedt, K., Wagner, M., Kullmer, U. et al. Cancer Causes Control (2008) 19: 909. doi:10.1007/s10552-008-9152-7

Abstract

Objective

To evaluate the effect of obesity on the presentation and course of disease in patients with gynecological cancers.

Study design

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.

Results

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 (pendometrial = 0.004 and pcervical = 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.

Conclusions

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.

Keywords

Body mass indexEndometrial cancerCervical cancerOvarian cancerPrognosisTumor biology

Copyright information

© Springer Science+Business Media B.V. 2008

Authors and Affiliations

  • Karsten Münstedt
    • 1
  • Mathias Wagner
    • 1
  • Uwe Kullmer
    • 2
  • Andreas Hackethal
    • 1
  • Folker E. Franke
    • 3
  1. 1.Department of Obstetrics and GynecologyClinic of the Universities Giessen and MarburgGiessenGermany
  2. 2.Department of Obstetrics and GynecologyAsklepios ClinicLichGermany
  3. 3.Institute of PathologyClinic of the Universities Giessen and MarburgGiessenGermany