Body mass index as a prognostic factor in endometrioid adenocarcinoma of the endometrium

J Natl Med Assoc. 2006 Nov;98(11):1814-22.

Abstract

Objective: To determine if body mass index (BMI) influences tumor expression of HER-2/neu, estrogen and progesterone receptors (ER/PR), and survival in women with endometrial adenocarcinoma.

Methods: Patients diagnosed between January 1992 and December 2001 with endometrioid adenocarcinoma of the uterus were identified. Clinical and pathologic data were retrospectively collected. HER-2/neu, estrogen and progesterone receptor expression were determined by immunohistochemistry. Differences in these variables and other prognostic factors were analyzed and correlated with effect on survival.

Results: One-hundred-sixty-five patients were included in this analysis. Lower BMI was associated with high stage (p=0.04) and HER-2/neu expression (p=0.04). Black race, high grade, high stage and lack of ER/PR expression were all associated with decreased survival. Despite having better prognostic factors, women with a BMI >25 had a lower survival than women with a BMI <25 (p=0.36). When five-year survival rates were calculated for BMI category and stratified by prognostic factors, for almost every high risk factor, survival was lower in overweight patients.

Conclusion: In patients with endometrioid adenocarcinoma, low BMI is associated with high stage and tumor expression of HER-2/neu. Despite better prognostic factors, overweight women experience poorer survival.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Body Mass Index*
  • Carcinoma, Endometrioid / genetics
  • Carcinoma, Endometrioid / mortality*
  • Carcinoma, Endometrioid / pathology
  • Carcinoma, Endometrioid / physiopathology*
  • Endometrial Neoplasms / genetics
  • Endometrial Neoplasms / mortality*
  • Endometrial Neoplasms / pathology
  • Endometrial Neoplasms / physiopathology*
  • Female
  • Humans
  • Immunohistochemistry
  • Middle Aged
  • Prognosis
  • Receptor, ErbB-2 / genetics
  • Survival Analysis

Substances

  • Receptor, ErbB-2