title: Impact of comorbid conditions on survival in endometrial cancer.
abstract: OBJECTIVE
  To evaluate the contribution of multiple medical comorbidities on the overall survival of endometrial cancer patients.
  
  
  METHODS
  The study evaluated 490 endometrial cancer patients stages I to IV who were treated between 1992 and 2008 with a hysterectomy with or without radiation therapy (RT). Hazard ratios (HR) were calculated for multiple variables including: diabetes mellitus (DM), hypertension (HTN), body mass index, smoking, RT, and years of estrogen exposure and then recalculated with an adjustment for age and grade as potential confounders.
  
  
  RESULTS
  In this study, 47% of patients had HTN, 26% had DM, 11% were smokers, 64% were stage I, 39% were grade 1, and 36% received RT. The presence of DM and HTN on univariate analysis resulted in decreased survival with [HR 1.70; 95% confidence interval (CI), 1.18-2.46] and (HR 1.66; 95% CI, 1.17-2.36), respectively. On multivariate analysis after correction for stage, age, and grade, DM and HTN continued to show a reduced survival rate (HR 1.58; 95% CI, 1.07-2.33 and HR 1.51; 95% CI, 1.06-2.15, respectively). Body mass index, smoking, parity, age at menarche, and years of estrogen exposure did not affect survival before or after correction for stage, age, and grade.
  
  
  CONCLUSIONS
  In this study, DM and HTN adversely effected survival. Given the favorable survival rate for most patients with endometrial cancer, attention to comorbid conditions, and particularly DM and HTN, is becoming more relevant for its implications on current health care and policy.
authors.affiliation: *Department of Radiation Oncology, Huntsman Cancer Hospital Departments of †Internal Medicine ‡Obstetrics and Gynecology, University of Utah School of Medicine, Salt Lake City, UT.
authors.forename: Zachary
authors.initials: Z
authors.lastname: Nicholas
authors.forename: Nan
authors.initials: N
authors.lastname: Hu
authors.forename: Jian
authors.initials: J
authors.lastname: Ying
authors.forename: Patrick
authors.initials: P
authors.lastname: Soisson
authors.forename: Mark
authors.initials: M
authors.lastname: Dodson
authors.forename: David K
authors.initials: DK
authors.lastname: Gaffney
mesh_terms: D000328:Adult; D015992:Body Mass Index; D015897:Comorbidity; D016001:Confidence Intervals; D003920:Diabetes Mellitus / Q000453:epidemiology*; D016889:Endometrial Neoplasms / Q000453:epidemiology / Q000401:mortality* / Q000532:radiotherapy / Q000601:surgery; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology*; D007044:Hysterectomy; D008572:Menarche; D008875:Middle Aged; D012189:Retrospective Studies; D015996:Survival Rate