title: The impact of BMI on quality of life in obese endometrial cancer survivors: does size matter?
abstract: BACKGROUND
  Survivorship and quality of life issues are becoming increasingly relevant in endometrial cancer as a result of the marked increase in incidence of the disease combined with excellent and improving long term survival.
  
  
  OBJECTIVE
  The purpose of this study was to evaluate the effect of obesity on quality of life (QoL) in endometrial cancer survivors.
  
  
  METHODS
  Participants were endometrioid endometrial cancer survivors diagnosed between 2008 and 2013. Quality of life was measured through the European Organisation for Research and Treatment of Cancer (EORTC) quality of life questionnaire (QLQ-C30, version 3.0). Associations between BMI and quality of life were determined by means of multivariate analyses.
  
  
  RESULTS
  322 women diagnosed with endometrioid endometrial cancer were invited to participate. Excluded were 15 women with unknown BMI, 40 with non-endometrioid histology and 10 with concurrent cancer. The QLQ-C30 questionnaire was completed by 158 (61.5%) women, of which 63 women (40%) were obese (BMI ≥ 30-39.9), and 30 women (19%) were morbidly obese (BMI ≥ 40). Morbidly obese women reported worse physical, role and social functioning and more somatic complaints.
  
  
  CONCLUSIONS
  Morbid obesity is associated with poorer quality of life in endometrial cancer survivors. Life style interventions such as exercise programs and diet interventions could be viable means to improve the quality of life of obese endometrial cancer survivors. Future research should focus on means to improve quality of life in obese endometrial cancer survivors.
authors.affiliation: Radboud UMC, Nijmegen, The Netherlands.
authors.forename: Anke
authors.initials: A
authors.lastname: Smits
authors.affiliation: Royal Cornwall Hospital, Truro, UK.
authors.forename: Alberto
authors.initials: A
authors.lastname: Lopes
authors.affiliation: Royal Cornwall Hospital, Truro, UK.
authors.forename: Nagindra
authors.initials: N
authors.lastname: Das
authors.affiliation: Obstetrics & Gynaecology Radboud UMC, Nijmegen, The Netherlands.
authors.forename: Ruud
authors.initials: R
authors.lastname: Bekkers
authors.affiliation: Royal Cornwall Hospital, Truro, UK. Electronic address: khadra.galaal@rcht.cornwall.nhs.uk.
authors.forename: Khadra
authors.initials: K
authors.lastname: Galaal
mesh_terms: D000368:Aged; D015992:Body Mass Index; D016889:Endometrial Neoplasms / Q000401:mortality* / Q000473:pathology / Q000523:psychology*; D005260:Female; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging; D009765:Obesity / Q000523:psychology*; D011788:Quality of Life; D017741:Survivors
keywords: Endometrioid endometrial cancer; Obesity; Quality of life (QoL); Survivorship