Introduction/Background Overweight and obesity are recognized as leading risk factors for endometrial cancer (EC). However, their impact on the clinicopathological features and survival outcomes of patients with EC remains controversial.
Methodology A single-center retrospective study of patients diagnosed with EC between 2015–2022 in Mexico City was conducted. Patients with available body mass index (BMI) at diagnosis and follow-up ≥12 months were eligible. Patients’ data were collected from electronic medical records. X2 and Fisher’s exact tests were used to evaluate associations between variables and BMI. Overall survival (OS) rates were calculated using the Kaplan-Meier method and compared according to BMI using the log-rank test. A Cox regression analysis was performed to estimate survival hazard ratios (HR).
Results Among 77 patients, the median age at diagnosis was 62 years (range 17–95), 50 (65%) had a high BMI (≥25 kg/m2), and 52 (68%) had endometrioid histology. Clinicopathological features according to BMI are shown in table 1. Patients with a high BMI were significantly more likely to have early-stage disease (p=0.013), lower CA-125 levels (p=0.041), and less lymphovascular invasion (LVI) (p=0.045).
With a median follow-up of 42 months (95%CI: 36, 49), 22 deaths were recorded, yielding a 3-year OS rate of 73%. In univariate analysis, patients with a high BMI had a significantly improved 3-year OS (79 vs. 63% [p=0.044]). In a multivariate analysis including stage, BMI, CA-125 levels, histologic subtype, grade, and LVI, only advanced stage at diagnosis (HR 9.6; p=0.012) remained significantly associated with worse OS.
Conclusion In our study, a high BMI was significantly associated with early-stage, lower CA-125 levels, and less LVI. However, no association was found between BMI and survival. Studies aimed at elucidating the mechanisms linking a high BMI to less aggressive clinicopathological features in patients with EC are further warranted.
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