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High BMI is significantly associated with positive progesterone receptor status and clinico-pathological markers for non-aggressive disease in endometrial cancer.

Mauland KK, Trovik J, Wik E, Raeder MB, Njølstad TS, Stefansson IM, Oyan AM, Kalland KH, Bjørge T, Akslen LA, Salvesen HB - Br. J. Cancer (2011)

Bottom Line: High BMI was significantly associated with low International Federation of Gynaecology and Obstetrics (FIGO) stage, endometrioid histology, low/intermediate grade, and high level of progesterone receptor (PR) mRNA by qPCR (n=150; P=0.02) and protein expression by immunohistochemistry (n=433; P=0.003).In contrast, oestrogen receptor (ERα) status was not associated with BMI.Overweight/obese women had significantly better disease-specific survival (DSS) than normal/underweight women in univariate analysis (P=0.035).

View Article: PubMed Central - PubMed

Affiliation: Department of Obstetrics and Gynaecology, Haukeland University Hospital, 5021 Bergen, Norway.

ABSTRACT

Background: Endometrial cancer incidence is increasing in industrialised countries. High body mass index (BMI, kg  m(-2)) is associated with higher risk for disease. We wanted to investigate if BMI is related to clinico-pathological characteristics, hormone receptor status in primary tumour, and disease outcome in endometrial cancer.

Patients and methods: In total, 1129 women primarily treated for endometrial carcinoma at Haukeland University Hospital during 1981-2009 were studied. Body mass index was available for 949 patients and related to comprehensive clinical and histopathological data, hormone receptor status in tumour, treatment, and follow-up.

Results: High BMI was significantly associated with low International Federation of Gynaecology and Obstetrics (FIGO) stage, endometrioid histology, low/intermediate grade, and high level of progesterone receptor (PR) mRNA by qPCR (n=150; P=0.02) and protein expression by immunohistochemistry (n=433; P=0.003). In contrast, oestrogen receptor (ERα) status was not associated with BMI. Overweight/obese women had significantly better disease-specific survival (DSS) than normal/underweight women in univariate analysis (P=0.035). In multivariate analysis of DSS adjusting for age, FIGO stage, histological subtype, and grade, BMI showed no independent prognostic impact.

Conclusion: High BMI was significantly associated with markers of non-aggressive disease and positive PR status in a large population-based study of endometrial carcinoma. Women with high BMI had significantly better prognosis in univariate analysis of DSS, an effect that disappeared in multivariate analysis adjusting for established prognostic markers. The role of PR in endometrial carcinogenesis needs to be further studied.

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Distribution of BMI for endometrial carcinoma patients treated in one defined region in Norway (Hordaland county) in the periods 1981–1990, 1991–2000, and 2001–2009. Median BMI and range increase significantly from 25.3 (16.9–44.5) to 26.7 (15.8–50.5) and 26.9 (14.7–73.0) for the time periods studied, P=0.002 (Kruskal–Wallis test). =minor outliers and =major outliers.
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fig1: Distribution of BMI for endometrial carcinoma patients treated in one defined region in Norway (Hordaland county) in the periods 1981–1990, 1991–2000, and 2001–2009. Median BMI and range increase significantly from 25.3 (16.9–44.5) to 26.7 (15.8–50.5) and 26.9 (14.7–73.0) for the time periods studied, P=0.002 (Kruskal–Wallis test). =minor outliers and =major outliers.

Mentions: The median BMI at diagnosis was 26.4 (range 14.7–73.0), with significantly increasing BMI throughout the study period, P=0.002 (Figure 1). There was a significant association between BMI and patient age at diagnosis, FIGO stage, and histological subtype, as shown in Table 1. The proportion of patients with BMI<25 was larger in the lower and upper age quartiles compared with BMI⩾25, whereas there was a tendency for the patients of the middle age quartiles to be overweight or obese. The proportion of normal/lean patients was larger for FIGO stages III and IV compared with FIGO stages I and II. High BMI was also associated with endometrioid histology. There was no significant association between BMI and menopausal status nor BMI and grade. Also, there was no significant difference in number of performed lymphadenectomies related to BMI (P=0.99), but a tendency to more adjuvant therapy given to patients with BMI<25 (P=0.06).


High BMI is significantly associated with positive progesterone receptor status and clinico-pathological markers for non-aggressive disease in endometrial cancer.

Mauland KK, Trovik J, Wik E, Raeder MB, Njølstad TS, Stefansson IM, Oyan AM, Kalland KH, Bjørge T, Akslen LA, Salvesen HB - Br. J. Cancer (2011)

Distribution of BMI for endometrial carcinoma patients treated in one defined region in Norway (Hordaland county) in the periods 1981–1990, 1991–2000, and 2001–2009. Median BMI and range increase significantly from 25.3 (16.9–44.5) to 26.7 (15.8–50.5) and 26.9 (14.7–73.0) for the time periods studied, P=0.002 (Kruskal–Wallis test). =minor outliers and =major outliers.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3065282&req=5

fig1: Distribution of BMI for endometrial carcinoma patients treated in one defined region in Norway (Hordaland county) in the periods 1981–1990, 1991–2000, and 2001–2009. Median BMI and range increase significantly from 25.3 (16.9–44.5) to 26.7 (15.8–50.5) and 26.9 (14.7–73.0) for the time periods studied, P=0.002 (Kruskal–Wallis test). =minor outliers and =major outliers.
Mentions: The median BMI at diagnosis was 26.4 (range 14.7–73.0), with significantly increasing BMI throughout the study period, P=0.002 (Figure 1). There was a significant association between BMI and patient age at diagnosis, FIGO stage, and histological subtype, as shown in Table 1. The proportion of patients with BMI<25 was larger in the lower and upper age quartiles compared with BMI⩾25, whereas there was a tendency for the patients of the middle age quartiles to be overweight or obese. The proportion of normal/lean patients was larger for FIGO stages III and IV compared with FIGO stages I and II. High BMI was also associated with endometrioid histology. There was no significant association between BMI and menopausal status nor BMI and grade. Also, there was no significant difference in number of performed lymphadenectomies related to BMI (P=0.99), but a tendency to more adjuvant therapy given to patients with BMI<25 (P=0.06).

Bottom Line: High BMI was significantly associated with low International Federation of Gynaecology and Obstetrics (FIGO) stage, endometrioid histology, low/intermediate grade, and high level of progesterone receptor (PR) mRNA by qPCR (n=150; P=0.02) and protein expression by immunohistochemistry (n=433; P=0.003).In contrast, oestrogen receptor (ERα) status was not associated with BMI.Overweight/obese women had significantly better disease-specific survival (DSS) than normal/underweight women in univariate analysis (P=0.035).

View Article: PubMed Central - PubMed

Affiliation: Department of Obstetrics and Gynaecology, Haukeland University Hospital, 5021 Bergen, Norway.

ABSTRACT

Background: Endometrial cancer incidence is increasing in industrialised countries. High body mass index (BMI, kg  m(-2)) is associated with higher risk for disease. We wanted to investigate if BMI is related to clinico-pathological characteristics, hormone receptor status in primary tumour, and disease outcome in endometrial cancer.

Patients and methods: In total, 1129 women primarily treated for endometrial carcinoma at Haukeland University Hospital during 1981-2009 were studied. Body mass index was available for 949 patients and related to comprehensive clinical and histopathological data, hormone receptor status in tumour, treatment, and follow-up.

Results: High BMI was significantly associated with low International Federation of Gynaecology and Obstetrics (FIGO) stage, endometrioid histology, low/intermediate grade, and high level of progesterone receptor (PR) mRNA by qPCR (n=150; P=0.02) and protein expression by immunohistochemistry (n=433; P=0.003). In contrast, oestrogen receptor (ERα) status was not associated with BMI. Overweight/obese women had significantly better disease-specific survival (DSS) than normal/underweight women in univariate analysis (P=0.035). In multivariate analysis of DSS adjusting for age, FIGO stage, histological subtype, and grade, BMI showed no independent prognostic impact.

Conclusion: High BMI was significantly associated with markers of non-aggressive disease and positive PR status in a large population-based study of endometrial carcinoma. Women with high BMI had significantly better prognosis in univariate analysis of DSS, an effect that disappeared in multivariate analysis adjusting for established prognostic markers. The role of PR in endometrial carcinogenesis needs to be further studied.

Show MeSH
Related in: MedlinePlus