Changes in weight or body mass index (BMI) around the time of endometrial cancer diagnosis are associated with reduced survival, according to a study published in JNCI: Journal of the National Cancer Institute.
The study showed that patients with a 5% or greater gain or loss in weight or BMI from 1 year before diagnosis to 4 months after diagnosis experienced a roughly 50% reduction in disease-free survival (DFS) and overall survival (OS).
“Monitoring of weight fluctuations at the time of endometrial cancer diagnosis coupled with interventions to assist these at-risk individuals may help improve survival in this population,” the researchers wrote.
For the study, the researchers assessed endometrial cancer survivors about 4 months after diagnosis (peri-diagnosis; n=540) and 3 years after diagnosis (follow up; n=425). These assessments included direct anthropometric measurements and self-reported lifetime weight history during in-person interviews.
At 4 months after diagnosis, the patients’ mean age was 59 years, the mean weight was 85 kg, and the mean waist circumference was 98 cm. Most patients (79.3%) had stage I cancers.
At a median follow-up of 14.2 years, 132 patients had disease recurrence or died. There were 50 deaths from endometrial cancer and 111 deaths overall.
The researchers found an association between reduced DFS and a BMI of 30 kg/m2 at 1 year before diagnosis (HR, 1.88; 95% CI, 1.09-3.22) and peri-diagnosis (HR, 2.04; 95% CI, 1.18-3.53).
The team also found an association between reduced DFS and a weight of 90.7 kg or greater 1 year before diagnosis (HR, 1.88; 95% CI, 1.15-3.07) and peri-diagnosis (HR, 1.60; 95% CI, 0.99-2.57).
Furthermore, a waist circumference of 88 cm or more peri-diagnosis was associated with reduced DFS (HR, 1.94; 95% CI, 1.24-3.03) and OS (HR, 1.90; 95% CI, 1.16-3.13).
Overall, there was a roughly 2-fold decrease in both DFS and OS with a 5% or greater change in BMI or weight from 1 year before diagnosis to peri-diagnosis.
“This observation aligns with previously reported associations between ≥10.0% weight change six months before cancer diagnosis and reduced survival,” the researchers wrote. “Different underlying biological mechanisms may contribute to the weight gain and weight loss survival associations.”
The researchers noted that future studies should include more sophisticated measurements of adiposity and body composition to further the understanding of the impact post-diagnosis weight has on survivorship.
Kokts-Porietis R, McNeil J, Morielli AR, et al. Prospective cohort study of pre- and post-diagnosis obesity and endometrial cancer survival. J Natl Cancer Inst. Published online October 1, 2021. doi:10.1093/jnci/djab197