Does visceral adiposity have an effect on the survival outcomes of the patients with endometrial cancer?

J Obstet Gynaecol Res. 2021 Feb;47(2):560-569. doi: 10.1111/jog.14560. Epub 2020 Nov 16.

Abstract

Aim: Endometrial cancer is the most common cancer of the female reproductive tract in the developed countries. There are many risk factors defined for the development of endometrial cancer, including obesity. We aimed to evaluate the significance of adiposity on the survival outcomes of the patients with endometrial cancer.

Methods: The patients diagnosed with endometrial cancer and underwent surgery between April 2009 and October 2017 were retrospectively reviewed. The visceral adipose tissue and subcutaneous adipose tissue volumes were measured at the level of umbilicus on single-slice magnetic resonance imaging. Visceral adiposity index was calculated. Patients were compared regarding their clinical, demographical, pathologic and survival characteristics. Patients divided into low visceral adiposity (≤0.265, group 1) and high visceral adiposity (>0.265, group 2).

Results: A total of 186 patients were included in this retrospective study. There was no significant difference in terms of the demographical, clinical and tumor characteristics of the patients, except age, menopausal status, subcutaneous adipose tissue and visceral adipose tissue. Although no significant difference in progression-free survival and disease-specific survival was noted between groups (P = 0.181), more patients in group 2 died because of endometrial cancer as statistically significant (P = 0.024). Disease-specific survival showed a significant difference between groups according to the log-rank test.

Conclusion: Visceral adiposity tissue is a significant and reliable prognostic indicator for endometrial cancer prognosis. Women diagnosed with endometrial cancer should be informed about the deleterious effects of visceral adiposity on disease-specific survival.

Keywords: adiposity; disease-specific survival; endometrial cancer; progression-free survival; subcutaneous adipose tissue; visceral adipose tissue.

MeSH terms

  • Adiposity*
  • Body Mass Index
  • Endometrial Neoplasms*
  • Female
  • Humans
  • Intra-Abdominal Fat / diagnostic imaging
  • Retrospective Studies
  • Subcutaneous Fat