Impact of Body Mass Index on Tumor Recurrence and Survival for Patients with Early Stage Endometrial Carcinoma after Adjuvant HDR Vaginal Cuff Brachytherapy

Brachytherapy ◽  
2013 ◽  
Vol 12 ◽  
pp. S55-S56
Author(s):  
Ibrahim Aref ◽  
Omar H. Gayar ◽  
Chad Cogan ◽  
Mohamed A. Elshaikh
Keyword(s):  
Body Mass Index ◽  
Endometrial Carcinoma ◽  
Body Mass ◽  
Tumor Recurrence ◽  
Early Stage ◽  
Vaginal Cuff

Does obesity influence the preferred treatment approach for early-stage cervical cancer? A cost-effectiveness analysis

2021 ◽  
pp. ijgc-2021-003004
Author(s):  
Jacqueline A Bohn ◽  
Miriam L Hernandez-Zepeda ◽  
Alyssa R Hersh ◽  
Elizabeth G Munro ◽  
Jenna M Kahn ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Cervical Cancer ◽  
Cost Effectiveness ◽  
Minimally Invasive ◽  
Body Mass ◽  
Radical Hysterectomy ◽  
Early Stage ◽  
Chemoradiation Therapy ◽  
The Body ◽  
Early Stage Cervical Cancer

ObjectiveAbdominal radical hysterectomy in early-stage cervical cancer has higher rates of disease-free and overall survival compared with minimally invasive radical hysterectomy. Abdominal radical hysterectomy may be technically challenging at higher body mass index levels resulting in poorer surgical outcomes. This study sought to examine the influence of body mass index on outcomes and cost effectiveness between different treatments for early-stage cervical cancer.MethodsA Markov decision-analytic model was designed using TreeAge Pro software to compare the outcomes and costs of primary chemoradiation versus surgery in women with early-stage cervical cancer. The study used a theoretical cohort of 6000 women who were treated with abdominal radical hysterectomy, minimally invasive radical hysterectomy, or primary chemoradiation therapy. We compared the results for three body mass index groups: less than 30 kg/m2, 30–39.9 kg/m2, and 40 kg/m2 or higher. Model inputs were derived from the literature. Outcomes included complications, recurrence, death, costs, and quality-adjusted life years. An incremental cost-effectiveness ratio of less than $100 000 per quality-adjusted life year was used as our willingness-to-pay threshold. Sensitivity analyses were performed broadly to determine the robustness of the results.ResultsComparing abdominal radical hysterectomy with minimally invasive radical hysterectomy, abdominal radical hysterectomy was associated with 526 fewer recurrences and 382 fewer deaths compared with minimally invasive radical hysterectomy; however, abdominal radical hysterectomy resulted in more complications for each body mass index category. When the body mass index was 40 kg/m2 or higher, abdominal radical hysterectomy became the dominant strategy because it led to better outcomes with lower costs than minimally invasive radical hysterectomy. Comparing abdominal radical hysterectomy with primary chemoradiation therapy, recurrence rates were similar, with more deaths associated with surgery across each body mass index category. Chemoradiation therapy became cost effective when the body mass index was 40 kg/m2 or higher.ConclusionWhen the body mass index is 40 kg/m2 or higher, abdominal radical hysterectomy is cost saving compared with minimally invasive radical hysterectomy and primary chemoradiation is cost effective compared with abdominal radical hysterectomy. Primary chemoradiation may be the optimal management strategy at higher body mass indexes.

scholarly journals Clinical Verification of Body Mass Index and Tumor Immune Response in Patients With Breast Cancer Receiving Preoperative Chemotherapy

2021 ◽  
Author(s):  
Koji Takada ◽  
Shinichiro Kashiwagi ◽  
Yuka Asano ◽  
Wataru Goto ◽  
Rika Kouhashi ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Body Mass Index ◽  
Body Mass ◽  
Preoperative Chemotherapy ◽  
Early Stage ◽  
Normal Weight ◽  
World Health ◽  
Cancer Type ◽  
Immune Microenvironment ◽  
Tumor Immune Microenvironment

Abstract PurposeThe body mass index (BMI) is commonly used as a simple indicator of obesity; patients with early-stage breast cancer who are obese (OB) per BMI measurements have been shown to have high postoperative recurrence and low survival rates. On the other hand, it has been shown that lymphocytes present in the vicinity of malignant growths that are involved in the tumors’ immune responses influence the efficacy chemotherapy. Therefore, we hypothesized that OB patients with breast cancer have a lower density of tumor-infiltrating lymphocytes (TILs), which may influence the therapeutic effect of preoperative chemotherapy (POC). In this study, we measured pretreatment BMI and TILs in patients with breast cancer who underwent POC, examined the correlations between these two factors, and retrospectively analyzed their therapeutic outcomes and prognoses.MethodsThe participants in this study were 421 patients with breast cancer who underwent surgical treatment after POC between February 2007 and January 2019. The patient’s height and weight were measured before POC to calculate the BMI (weight [kg] divided by the square of the height [m2]). According to the World Health Organization categorization, patients who weighed under 18.5 kg/m2 were classified as underweight (UW), those ≥18.5 kg/m2 and >25 kg/m2 were considered normal weight (NW), those ≥25 kg/m2 and <30 kg/m2 were overweight (OW), and those ≥30 kg/m2 were OB. The TILs were those lymphocytes that infiltrated the tumor stroma according to the definition of the International TILs Working Group 2014.ResultsThe median BMI was 21.9 kg/m2 (range, 14.3–38.5 kg/m2); most patients (244; 64.5%) were NW. Among all 378 patients with breast cancer, the TIL density was significantly lower in OB than in NW and OW patients (vs. NW: p=0.001; vs. OW: p=0.003). Furthermore, when examining patients with each breast cancer type individually, the OS of those with TNBC who had low BMIs was significantly poorer than that of their high-BMI counterparts (log rank p=0.031).ConclusionsOur data did not support the hypothesis that obesity affects the tumor immune microenvironment; however, we showed that being UW does affect the tumor immune microenvironment.

scholarly journals Clinical and histopathological characteristics in patients with postmenopausal bleeding

2013 ◽  
Vol 21 (1) ◽  
pp. 5-10 ◽  
Author(s):  
Aljosa Mandic ◽  
Bojana Gutic ◽  
Tatjana Kapicl-Ivkovic ◽  
Ljiljana Segedi-Mladenovic ◽  
Mihaela Mocko-Kacanski
Keyword(s):  
Body Mass Index ◽  
Risk Factor ◽  
Endometrial Carcinoma ◽  
Body Mass ◽  
Transvaginal Ultrasound ◽  
Significant Risk ◽  
Histopathological Analysis ◽  
Postmenopausal Bleeding ◽  
Postmenopausal Period ◽  
Increased Risk

Background: Incidence of endometrial carcinoma in Vojvodina is 15-20/100 000. In 75% cases, endometrial carcinoma is diagnosed in postmenopausal period. In 90 % of patients, the first clinical sign is postmenopausal bleeding. The aim of the study was to investigate clinical and histopathological characteristics in patients with postmenopausal bleeding. Methods: The study included 122 patients with postmenopausal bleeding. All of these patients underwent gynecological examination and vaginal ultrasound. We obtained materials for histopathological analysis by fractionate explorative curettage. Once we had definitive histopathological findings, we divided patients in two groups A (endometrial carcinoma) and B (benign changes). Results: We confirmed significant statistical differences between examined group A and B, including age (64.49 compared with 58.81 years), postmenopausal period (13.67 instead 9.11 years), and length of uterine corpus (6.41 instead 5.25 cm). Conclusion: Elderly women with longer postmenopausal interval and postmenopausal bleeding had increased risk for endometrial carcinoma. Measurement of endometrial thickness by transvaginal ultrasound appeared to be insufficient parameter for differentiating the benign from the malignant changes of endometrium. Patients with endometrial carcinoma had significantly longer corpus of uterus comparing to patients with benign changes. Body mass index was not found to be significant risk factor in development of endometrial carcinoma in the examined groups. Obesity was diagnosed in both groups, suggesting that increased body mass index is a risk factor for development of pathological changes in endometrium, which could lead to postmenopausal bleeding.

A high body mass index is not a worse prognostic factor for endometrial carcinoma in a predominantly obese population

2012 ◽  
Vol 15 (3) ◽  
pp. 243-247 ◽  
Author(s):  
Leonardo Saúl Lino-Silva ◽  
David Cantú de León ◽  
Rosa Angélica Salcedo-Hernández ◽  
Claudia Cavazos-Saman ◽  
María Delia Pérez-Montiel
Keyword(s):  
Body Mass Index ◽  
Prognostic Factor ◽  
Endometrial Carcinoma ◽  
Body Mass ◽  
High Body Mass Index ◽  
High Body ◽  
Obese Population

Impact of breast cancer treatment on body mass index (BMI) over time.

2015 ◽  
Vol 33 (28_suppl) ◽  
pp. 94-94
Author(s):  
Raquel E. Reinbolt ◽  
Xueliang Jeff Pan ◽  
Kaitlin K. Wandell ◽  
Robert Pilarski ◽  
Rachel M. Layman ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Body Mass Index ◽  
Weight Gain ◽  
Cancer Patients ◽  
Endocrine Therapy ◽  
Body Mass ◽  
Early Stage ◽  
Early Stage Breast Cancer ◽  
Cancer Tissue ◽  
Breast Cancer Patients

94 Background: Weight gain concerns breast cancer patients, can impact quality of life, may lead to therapy non-adherence, and is associated with increased recurrence risk and mortality. Early placebo-controlled trials did not identify a clear correlation between Tamoxifen (TAM) and weight gain; gain due to aromatase inhibitors (AIs) is not well characterized. We hypothesized that weight gain occurs more frequently than previously reported in breast cancer patients receiving endocrine therapy. Methods: This is a retrospective chart review investigating body mass index (BMI) change in women after breast cancer therapy. Patients with early stage breast cancer and whom had BMI and treatment data (at least 90 days) from 2003-2012 were identified in The Columbus Breast Cancer Tissue Bank. Patients were separated by treatment received: chemotherapy with and without endocrine therapy vs. endocrine therapy alone (including both TAM and AIs) vs. no other treatment. Results: A total of 970 subjects were included in the analysis. At diagnosis and/or treatment initiation, patients’ mean BMI was 29.2 ± 7.0 kg/m2; mean age 53.7± 11.6 years; and average length of therapy/follow up per patient, 1833 days (range 90-3,990). Patients who received an AI alone had significantly decreased BMIs during therapy (-0.65± 0.29 kg/m2, p = 0.025), whereas patients receiving chemotherapy alone, chemotherapy with TAM, or TAM followed by AI therapy, had significantly increased BMIs (0.51 ± 0.25, 0.73 ± 0.26, 1.01 ± 0.51 kg/m2; p = 0.039, 0.005, 0.045, respectively). Both older age and a higher BMI at diagnosis were associated with a significantly greater decline in BMI over treatment time (p < 0.001 and p < 0.001, respectively). In a multivariate regression model, after adjusting for age and initial BMI effect, the BMI change noted among different treatment groups was no longer significantly different (p = 0.43). BMI change was not statistically associated with treatment length (p = 0.26). Conclusions: Our review of a large, early stage breast cancer patient cohort showed no association between weight gain and endocrine therapy after adjusting for the effect of initial BMI and age at diagnosis. Additional study is needed to identify other factors impacting weight in this population.

Body mass index does not influence post-treatment survival in early stage endometrial cancer: Results from the MRC ASTEC trial

2012 ◽  
Vol 48 (6) ◽  
pp. 853-864 ◽  
Author(s):  
Emma J. Crosbie ◽  
Chris Roberts ◽  
Wendi Qian ◽  
Ann Marie Swart ◽  
Henry C. Kitchener ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Endometrial Cancer ◽  
Body Mass ◽  
Early Stage ◽  
Post Treatment ◽  
Early Stage Endometrial Cancer

scholarly journals Clinical verification of body mass index and tumor immune response in patients with breast cancer receiving preoperative chemotherapy

2021 ◽  
Author(s):  
Koji Takada ◽  
Shinichiro Kashiwagi ◽  
Yuka Asano ◽  
Wataru Goto ◽  
Rika Kouhashi ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Body Mass Index ◽  
Body Mass ◽  
Preoperative Chemotherapy ◽  
Early Stage ◽  
The Body ◽  
World Health ◽  
Cancer Type ◽  
Immune Microenvironment ◽  
Tumor Immune Microenvironment

Abstract Purpose: The body mass index (BMI) is commonly used as a simple indicator of obesity; patients with early-stage breast cancer who are obese (OB) per BMI measurements have been shown to have high postoperative recurrence and low survival rates. On the other hand, it has been shown that lymphocytes present in the vicinity of malignant growths that are involved in the tumors’ immune responses influence the efficacy chemotherapy. Therefore, we hypothesized that OB patients with breast cancer have a lower density of tumor-infiltrating lymphocytes (TILs), which may influence the therapeutic effect of preoperative chemotherapy (POC). In this study, we measured pretreatment BMI and TILs in patients with breast cancer who underwent POC, examined the correlations between these two factors, and retrospectively analyzed their therapeutic outcomes and prognoses.Methods: The participants in this study were 421 patients with breast cancer who underwent surgical treatment after POC between February 2007 and January 2019. The patient’s height and weight were measured before POC to calculate the BMI (weight [kg] divided by the square of the height [m2]). According to the World Health Organization categorization, patients who weighed under 18.5 kg/m2 were classified as underweight (UW), those ≥18.5 kg/m2 and >25 kg/m2 were considered normal weight (NW), those ≥25 kg/m2 and <30 kg/m2 were overweight (OW), and those ≥30 kg/m2 were OB. The TILs were those lymphocytes that infiltrated the tumor stroma according to the definition of the International TILs Working Group 2014.Results: The median BMI was 21.9 kg/m2 (range, 14.3–38.5 kg/m2); most patients (244; 64.5%) were NW. Among all 378 patients with breast cancer, the TIL density was significantly lower in OB than in NW and OW patients (vs. NW: p=0.001; vs. OW: p=0.003). Furthermore, when examining patients with each breast cancer type individually, the OS of those with TNBC who had low BMIs was significantly poorer than that of their high-BMI counterparts (log rank p=0.031).Conclusions: Our data did not support the hypothesis that obesity affects the tumor immune microenvironment; however, we showed that being UW does affect the tumor immune microenvironment.

scholarly journals Role of age of incidence, parity, body mass index and socioeconomic class in endometrial carcinoma

2020 ◽  
Vol 9 (2) ◽  
pp. 762
Author(s):  
Neha A. Nimbark
Keyword(s):  
Body Mass Index ◽  
Endometrial Carcinoma ◽  
Body Mass ◽  
Descriptive Statistics ◽  
Age Group ◽  
Socioeconomic Class ◽  
Frequency Table ◽  
Number Of Patients ◽  
A Prospective Study

Background: Endometrial carcinoma is the most common gynecologial malignancy in world. The main aim is to study epidemiological factors of Ca body uterus in our hospital. The present study was designed to evaluate the age of incidence of carcinoma body uterus and study role of parity, body mass index and socioeconomic class in carcinoma body.Methods: This is a prospective study of 50 cases of endometrial carcinoma who were treated in a single unit of the hospital from April 2010 to March 2012 (2 years) conducted at the department of gynaecological oncology G. C. R. I., Ahmedabad. Observational study was done. All these data were combined and tabulated in frequency table simple percentage analysis is used for frequency and percentage analysis is applied to create a contingency table from the frequency distribution and represent the collected data for better understanding. Descriptive statistics were obtained for all variable.Results: Maximum number of patients were in age group of 50-59 years. Mean age was 58 years. Maximum patients were multiparous (54%). 4 patients were nulligravida (9%). 70% were overweight and obese. Majority of patients (72%) belong to middle and higher socio-economic class.Conclusions: It was noted that the incidence for ca endometrium is related to age, parity, BMI and socioeconomic class at our centre.

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