Prospective Cohort Study of Pre- and Post-Diagnosis Obesity and Endometrial Cancer Survival
Menée auprès de 540 et 425 patientes ayant survécu à un cancer de l'endomètre diagnostiqué entre 2002 et 2006, cette étude de cohorte prospective analyse l'association entre une obésité, mesurée avant et après le diagnostic de cancer, et la survie
Résumé en anglais
Background : Disease-free and overall survival associations with anthropometric measures of obesity and changes in these exposures remain unknown among endometrial cancer survivors.
Methods : Endometrial cancer survivors diagnosed between 2002–2006 completed direct anthropometric measurements and self-reported lifetime weight history during in-person interviews approximately 4 months after diagnosis (peri-diagnosis) and approximately 3 years after diagnosis (follow-up). Participants were followed until death or March 20, 2019. Cox proportional regression estimated multivariable-adjusted hazard ratios (HR) and 95% confidence intervals (CI) for body mass index (BMI), weight, waist circumference, and waist-hip ratio with disease-free survival (DFS) and overall survival (OS). Statistical tests were two-sided.
Results : 540 and 425 cancer survivors were assessed peri-diagnosis and follow-up, respectively. During the median 14.2 years of follow-up (range = 0.3–16.5 years), 132 participants had a recurrence and/or died (DFS) with 111 deaths overall (OS). Reduced DFS was noted with greater recalled weight one-year before-diagnosis (HR = 1.88, 95% CI = 1.15 to 3.07), BMI one-year before-diagnosis (HR = 1.88, 95% CI = 1.09 to 3.22), and measured peri-diagnosis BMI (HR = 2.04, 95% CI = 1.18 to 3.53). Measured peri-diagnosis waist circumference ≥88 cm was associated with decreased DFS (HR = 1.94, 95% CI = 1.24 to 3.03) and OS (HR = 1.90, 95% CI = 1.16 to 3.13). A two-fold decrease in DFS and OS was associated with ≥5% BMI or weight change from one-year before diagnosis to peri-diagnosis. No associations were observed for the assessment during follow-up.
Conclusion : One-year before- and peri-diagnosis anthropometric measures of obesity were associated with reduced survival among endometrial cancer survivors. Anthropometric changes from one-year before- to peri-diagnosis may provide an important indication of future survival in this population.
