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Endometrium Kanserinde Vücut Kitle İndeksinin Prognostik Faktörler ve Sağkalım ile İlişkisi

Yıl 2020, Cilt: 3 Sayı: 3, 94 - 99, 29.10.2020

Öz

Amaç: Endometriyum kanseri tanısı almış hastalarda vücut kitle indeksinin prognostik faktörler ve sağkalıma etkisinin araştırılmasıdır.
Yöntem: Bu çalışma tek merkezli retrospektif klinik çalışmadır. Endometriyum kanseri tanısı almış 247 hasta değerlendirilmiştir. Hastaların VKİ’si, tanı yaşı, menapoz durumları, tümör çapı, tümörün histopatolojik tipi, gradı, evresi, myometriyal invazyon, servikal invazyon, lenf nodu tutulumu, RT durumu, RT tipi, aldığı KT rejimleri, nüks ve metastaz durumları, hastalıksız sağkalım ve genel sağkalımları belirlendi. VKİ’nin prognostik faktörlerle ilişkisi ki-kare testi, sağkalım analizi ise Kaplan-meier ve cox analizi kullanılarak değerlendirilmiştir.
Bulgular: Hastaların VKİ’i <30 kg/m2, 30-39,9 kg/m2, ≥40 kg/m2 olmak üzere 3 gruba kategorize edildi. Prognostik faktörlerden yaş, menapoz durum, histolojik alt tip, tümör çapı, grade, evre, servikal invazyon, myometriyal invazyon, lenf nodu tutulumu ile VKİ ile ilişkisi incelenmiştir. VKİ ile grad arasında ilişki anlamlı olup diğer prognostik faktörler ile ilişkisi istatistiksel anlamlı değildi. Genel sağkalım ve hastalıksız sağkalıma etki eden faktörler çok değişkenli analiz ile incelendiğinde evre ve histolojik alt tip istatiksel olarak anlamlı bulunmuştur. VKİ’nin genel sağkalım ve hastalıksız sağkalıma etkisi anlamlı bulunmamıştır.
Sonuç: Hastaların VKİ’si ile gradı arasında istatistiksel anlamlı ters bir ilişki vardı. Ancak bu etkinin genel ve hastalıksız sağkalıma etkisi gösterilememiştir. Evre ve histoloji genel ve hastalıksız sağkalımı etkilemektedir.

Proje Numarası

KU GOKAEK 2018/59

Kaynakça

  • 1. Torre LA, Bray F, Siegel RL, et al. Global cancer statistics, 2012. CA Cancer J Clin. 2015;65(2):87.
  • 2. Siegel R, Naishadham D,Jemal A. Canser statistics, 2012. CA Cancer J Clin. 2012;62(1):10–29.
  • 3. Ali AT. Risk factors for endometrial cancer. Ceska Gynekol.. 2013;78(5):448-459.
  • 4. Reeves KW, Carter GC, Rodabough RJ, et al. Obesity in relation to endometrial cancer risk and disease characteristics in the Women’s Health Initiative. Gynecol Oncol. 2011;121(2):376–382.
  • 5. Flegal KM, Kruszon-Moran D, Carroll MD, Fryar CD, Ogden CL. Trends in obesity among adults in the United States, 2005 to 2014. JAMA.2016;315(21):2284-2291.
  • 6. World Cancer Research Fund/American Institute for Cancer Research: Continuous Update Project Report. Food: Nutrition, Physical Activity, and the Prevention of Endometrial Cancer. 2013.
  • 7. McCullough ML, Patel AV, Patel R, et al. Body mass and endometrial cancer risk by hormone replacement therapy and cancer subtype. Cancer Epidemiol Biomarkers Prev. 2008;17(1):73-79.
  • 8. Smits A, Lopez A, Das N, Bekkers R, Galaal K. The impacts of BMI on quality of life in obese endometrial cancer survivors: Does size matter? Gynecol Oncol. 2014;132(1):137-141.
  • 9. Bokhman JV. Two pathogenetic types of endometrial carcinoma. Gynecol Oncol 1983;15(1):10-17.
  • 10. National Cancer Institute. SEER stat fact sheets: endometrial cancer. Surveillance, Epidemiology, and End Results (SEER) Program. Available at http://seer.cancer.gov/statfacts/html/corp.html. Accessed: May 06, 2019.
  • 11. Lee NK, Cheung MK, Shin JY,Husain A, Teng NN, Berek JS, et al. Prognostic factors for uterine cancer in reproductive-aged women. Obstet Gynecol. 2007;109(3):655–662.
  • 12. Lurain JR, Rice BL, Rademaker AW, Poggensee LE, Schink JC, Miller DS. Prognostic factors associated with recurrence in clinical stage I adenocarcinoma of the endometrium. Obstet Gynecol. 1991;78(1):63–69.
  • 13. Bourgin C, Saidani M, Poupon C, et al. Endometrial cancer in elderly women: which disease, which surgical management? A systematic review of the literature. EJSO - European Journal of Surgical Oncology.2016;42(2):166-175.
  • 14. Keys HM, Roberts JA, Brunetto VLet al. A Phase III trial of surgery with or without adjunctive external pelvic radiation therapy in intermediate risk endometrial adenocarcinoma: a Gynecologic Oncology Group study. Gynecol Oncol. 2004;92(3):744–751.
  • 15. Nevadunsky NS, van Arsdale A, Strickler HD, et al. Obesity and age at diagnosis of endometrial cancer. Obstet Gynecol. 2014;124(2):300-306.
  • 16. Choi E, Kim J, Kim O, Byun S, Park S, Kwon S. Postoperative radiotherapy for endometrial cancer. Radiation Oncology Journal.2012;30(3):108-116.
  • 17. Painter JN, O’mara TA, Marquart L, et al. Genetic risk score mendelian randomization shows that obesity measured as body mass index, but not waist:hip ratio, is casual for endometrial cancer. Cancer Epidemiol Biomarkers Prev. 2016;25(11):1503-1510.
  • 18. Temkin SM, Pezzullo JC, Hellmann M, Lee YC, Abulafia O. Is body mass index an independent risk factor of survival among patients with endometrial cancer? Am J Clin Oncol. 2007;30(1):8-14.
  • 19. Lépine J, Audet-Walsh E, Grégoire J, et al. Circulating estrogens in endometrial cancer cases and ththeir relationship with tissular expression of key estrogen biosynthesis and metabolic pathway. J Clin Endocrinol Metab. 2010;95(6):2689-2698.
  • 20. Lewin SN, Herzog TJ, Barrena Medel NI, et al. Comparative performance of the 2009 international Federation of gynecology and obstetrics' staging system for uterine corpus cancer. Obstet Gynecol. 2010;116(5):1141-1149.
  • 21. Canlorbe G, Bendifallah S, Raimond E, et al. Severe obesity impacts recurrence-free survival of women with high-risk endometrial cancer: results of a French multicenter study. Ann Surg Oncol. 2015;22(8):2714-2721.
  • 22. Ko M, Walter P, Clark L, et al. The complex triad of obesity, diabetes and race in type I and II endometrial cancers: prevelance and prognostic significance. Gyncol Oncol. 2014;133(1):28-32.
  • 23. Cohn DE, Woeste EM, Cacchio S, Zanagnolo VL, Havrilesky LJ, Mariani A. Clinical and pathologic correlates in surgical stage II endometrial carcinoma. Obstet Gynecol. 2007;109(5):1062-1067.
  • 24. Billingsley CC, Cansino C, O’Malley DM, Cohn DE, Fowler JM, Copeland LJ. Survival outcomes of obese patients in type II endometrial cancer: defining the prognostic impact of increasing BMI. Gynecol Oncol. 2016;140(3):405-408.
  • 25. Gunderson CC, Java J, Moore KN, Walker JL. The impact of obesity on surgical staging, complications, and survival with uterine cancer: a gynecolologic oncology group LAP2 ancillary data study. Gynecol Oncol. 2014;133(1):23-27.
  • 26. Everett E, Tamimi H, Greer B. The effect of body mass index on clinical/pathologic features surgical morbidity, and outcome in patients with endometrial cancer. Gynecol Oncol. 2003;90(1):150-157.

RELATIONSHIPS OF BODY MASS INDEX WITH PROGNOSTIC FACTORS AND SURVIVAL IN ENDOMETRIAL CANCER

Yıl 2020, Cilt: 3 Sayı: 3, 94 - 99, 29.10.2020

Öz

Objective: The aim of the study is to investigate the effect of body mass index (BMI) on prognostic factors and survival in patients with endometrial cancer.
Methods: A total of 247 patients with endometrial cancer were evaluated. The BMI, age of diagnosis, menopausal status, tumor size, histopathological type of tumor, tumor grade, myometrial invasion, cervical invasion, lymph node involvement, radiotherapy (RT) status, RT type, chemotherapy (KT) regimens, recurrence and metastasis status, disease-free survival and overall survival of the patients were determined retrospectively. The relationship between BMI and prognostic factors is evaluated with chi-square test and survival analysis is evaluated using Kaplan-meier and cox analysis. The BMI of the patients were categorized into 3 groups as <30 kg / m2, 30-39,9 kg / m2, ≥40 kg / m2. Age, menopausal status, histological subtype, tumor size, grade, stage, cervical invasion, myometrial invasion, lymph node involvement and relationship with BMI were investigated.
Results: The relationship between BMI and grade was significant but its relationship with other prognostic factors was not statistically significant. When the factors affecting overall survival and disease-free survival were analyzed by multivariate analysis, the stage and histological subtypes were found statistically significant. The effect of BMI on overall survival and disease-free survival was not significant.
Conclusion: There was a statistically significant inverse relationship between BMI and grade. However, there was no relationship between BMI and overall survival and disease-free survival. The stage and histological subtypes affected DFS and OS.

Proje Numarası

KU GOKAEK 2018/59

Kaynakça

  • 1. Torre LA, Bray F, Siegel RL, et al. Global cancer statistics, 2012. CA Cancer J Clin. 2015;65(2):87.
  • 2. Siegel R, Naishadham D,Jemal A. Canser statistics, 2012. CA Cancer J Clin. 2012;62(1):10–29.
  • 3. Ali AT. Risk factors for endometrial cancer. Ceska Gynekol.. 2013;78(5):448-459.
  • 4. Reeves KW, Carter GC, Rodabough RJ, et al. Obesity in relation to endometrial cancer risk and disease characteristics in the Women’s Health Initiative. Gynecol Oncol. 2011;121(2):376–382.
  • 5. Flegal KM, Kruszon-Moran D, Carroll MD, Fryar CD, Ogden CL. Trends in obesity among adults in the United States, 2005 to 2014. JAMA.2016;315(21):2284-2291.
  • 6. World Cancer Research Fund/American Institute for Cancer Research: Continuous Update Project Report. Food: Nutrition, Physical Activity, and the Prevention of Endometrial Cancer. 2013.
  • 7. McCullough ML, Patel AV, Patel R, et al. Body mass and endometrial cancer risk by hormone replacement therapy and cancer subtype. Cancer Epidemiol Biomarkers Prev. 2008;17(1):73-79.
  • 8. Smits A, Lopez A, Das N, Bekkers R, Galaal K. The impacts of BMI on quality of life in obese endometrial cancer survivors: Does size matter? Gynecol Oncol. 2014;132(1):137-141.
  • 9. Bokhman JV. Two pathogenetic types of endometrial carcinoma. Gynecol Oncol 1983;15(1):10-17.
  • 10. National Cancer Institute. SEER stat fact sheets: endometrial cancer. Surveillance, Epidemiology, and End Results (SEER) Program. Available at http://seer.cancer.gov/statfacts/html/corp.html. Accessed: May 06, 2019.
  • 11. Lee NK, Cheung MK, Shin JY,Husain A, Teng NN, Berek JS, et al. Prognostic factors for uterine cancer in reproductive-aged women. Obstet Gynecol. 2007;109(3):655–662.
  • 12. Lurain JR, Rice BL, Rademaker AW, Poggensee LE, Schink JC, Miller DS. Prognostic factors associated with recurrence in clinical stage I adenocarcinoma of the endometrium. Obstet Gynecol. 1991;78(1):63–69.
  • 13. Bourgin C, Saidani M, Poupon C, et al. Endometrial cancer in elderly women: which disease, which surgical management? A systematic review of the literature. EJSO - European Journal of Surgical Oncology.2016;42(2):166-175.
  • 14. Keys HM, Roberts JA, Brunetto VLet al. A Phase III trial of surgery with or without adjunctive external pelvic radiation therapy in intermediate risk endometrial adenocarcinoma: a Gynecologic Oncology Group study. Gynecol Oncol. 2004;92(3):744–751.
  • 15. Nevadunsky NS, van Arsdale A, Strickler HD, et al. Obesity and age at diagnosis of endometrial cancer. Obstet Gynecol. 2014;124(2):300-306.
  • 16. Choi E, Kim J, Kim O, Byun S, Park S, Kwon S. Postoperative radiotherapy for endometrial cancer. Radiation Oncology Journal.2012;30(3):108-116.
  • 17. Painter JN, O’mara TA, Marquart L, et al. Genetic risk score mendelian randomization shows that obesity measured as body mass index, but not waist:hip ratio, is casual for endometrial cancer. Cancer Epidemiol Biomarkers Prev. 2016;25(11):1503-1510.
  • 18. Temkin SM, Pezzullo JC, Hellmann M, Lee YC, Abulafia O. Is body mass index an independent risk factor of survival among patients with endometrial cancer? Am J Clin Oncol. 2007;30(1):8-14.
  • 19. Lépine J, Audet-Walsh E, Grégoire J, et al. Circulating estrogens in endometrial cancer cases and ththeir relationship with tissular expression of key estrogen biosynthesis and metabolic pathway. J Clin Endocrinol Metab. 2010;95(6):2689-2698.
  • 20. Lewin SN, Herzog TJ, Barrena Medel NI, et al. Comparative performance of the 2009 international Federation of gynecology and obstetrics' staging system for uterine corpus cancer. Obstet Gynecol. 2010;116(5):1141-1149.
  • 21. Canlorbe G, Bendifallah S, Raimond E, et al. Severe obesity impacts recurrence-free survival of women with high-risk endometrial cancer: results of a French multicenter study. Ann Surg Oncol. 2015;22(8):2714-2721.
  • 22. Ko M, Walter P, Clark L, et al. The complex triad of obesity, diabetes and race in type I and II endometrial cancers: prevelance and prognostic significance. Gyncol Oncol. 2014;133(1):28-32.
  • 23. Cohn DE, Woeste EM, Cacchio S, Zanagnolo VL, Havrilesky LJ, Mariani A. Clinical and pathologic correlates in surgical stage II endometrial carcinoma. Obstet Gynecol. 2007;109(5):1062-1067.
  • 24. Billingsley CC, Cansino C, O’Malley DM, Cohn DE, Fowler JM, Copeland LJ. Survival outcomes of obese patients in type II endometrial cancer: defining the prognostic impact of increasing BMI. Gynecol Oncol. 2016;140(3):405-408.
  • 25. Gunderson CC, Java J, Moore KN, Walker JL. The impact of obesity on surgical staging, complications, and survival with uterine cancer: a gynecolologic oncology group LAP2 ancillary data study. Gynecol Oncol. 2014;133(1):23-27.
  • 26. Everett E, Tamimi H, Greer B. The effect of body mass index on clinical/pathologic features surgical morbidity, and outcome in patients with endometrial cancer. Gynecol Oncol. 2003;90(1):150-157.
Toplam 26 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Onkoloji ve Karsinogenez
Bölüm Araştırma Makaleleri
Yazarlar

Emel Merve Yenihayat 0000-0003-4259-3732

Umut Kefeli 0000-0001-6126-5377

Devrim Çabuk 0000-0002-7871-6311

Ulaş Işık 0000-0002-4800-1665

Ercan Özden 0000-0002-1583-6068

Yağmur Çakmak 0000-0001-5777-1066

Kazım Uygun 0000-0002-4339-9918

Proje Numarası KU GOKAEK 2018/59
Yayımlanma Tarihi 29 Ekim 2020
Gönderilme Tarihi 5 Eylül 2020
Kabul Tarihi 5 Ekim 2020
Yayımlandığı Sayı Yıl 2020 Cilt: 3 Sayı: 3

Kaynak Göster

AMA Yenihayat EM, Kefeli U, Çabuk D, Işık U, Özden E, Çakmak Y, Uygun K. RELATIONSHIPS OF BODY MASS INDEX WITH PROGNOSTIC FACTORS AND SURVIVAL IN ENDOMETRIAL CANCER. Acta Med Nicomedia. Ekim 2020;3(3):94-99.

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