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http://crossmark.crossref.org/dialog/?doi=10.1245/s10434-016-5237-9&domain=pdf
Web End = Ann Surg Oncol (2016) 23:29882997 DOI 10.1245/s10434-016-5237-9
http://crossmark.crossref.org/dialog/?doi=10.1245/s10434-016-5237-9&domain=pdf
Web End = ORIGINAL ARTICLE GYNECOLOGIC ONCOLOGY
Weight Change Pattern and Survival Outcome of Women with Endometrial Cancer
Koji Matsuo, MD, PhD1,3, Aida Moeini, MD1, Sigita S. Cahoon, MD1, Hiroko Machida, MD1, Marcia A. Ciccone, MD1, Brendan H. Grubbs, MD2, and Laila I. Muderspach, MD1,3
1Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Los Angeles County Medical Center, University of Southern California, Los Angeles, CA ; 2Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Los Angeles County Medical Center, University of Southern California, Los Angeles, CA; 3Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA
ABSTRACTObjective. The aim of this study was to determine the association between weight change patterns and survival outcomes of women with endometrial cancer.
Methods. This retrospective study examined surgically-staged endometrial cancer cases with available weight information between 1999 and 2013 (n = 665). Proportional body mass index (delta-BMI) change at 6 months, 1 and 2 years after hysterectomy was compared with baseline BMI and correlated to patient demographics, tumor characteristics, treatment type, and disease-free survival (DFS) and overall survival (OS).
Results. Mean BMI was 35.6, and 69 % of cases were obese. At 6 months, 1 and 2 years after surgery, 39.1, 51.6, and 57.0 % of the study population, respectively, gained weight compared with pre-treatment baseline. In univariate analysis, 6-month delta-BMI change was signicantly associated with DFS and OS, demonstrating bidirectional effects (both p \ 0.001): 5-year rates, C15.0 % delta-BMI loss (33.5 and 59.1 %), 7.514.9 % loss (67.3 and 70.0 %), \7.5 % loss (87.8 and 95.7 %), \7.5 % gain (87.2 and
90.3 %), 7.514.9 % gain (64.6 and 67.6 %), and C15.0 % gain (32.5 and 66.7 %). In multivariable analysis controlling for age, ethnicity, baseline BMI, histology, grade, stage, chemotherapy, and radiotherapy, 6-month delta-BMI change remained an independent prognostic factor for DFS and OS (all p \ 0.05): adjusted hazard ratios, C15 % delta-
BMI loss (3.35 and 5.39), 7.514.9 % loss (2.35 and 4.19),7.514.9 % gain (2.58 and 3.33), and C15.0 % gain (2.50 and 3.45) compared with \7.5 % loss. Similar ndings were observed at a 1-year time point (p \ 0.05). Baseline
BMI was not associated with...