title: Body mass index and the quality of life of endometrial cancer survivors--a systematic review and meta-analysis.
abstract: BACKGROUND
  Obesity is a risk factor for developing endometrial cancer and known to negatively affect outcomes and survival. However, the association between obesity and quality of life of endometrial cancer survivors (ECS) remains unclear.
  
  
  OBJECTIVE
  To assess the association between body mass index (BMI) and the quality of life of endometrial cancer survivors. In addition we assessed the associations between BMI and anxiety, depression and sexual function of endometrial cancer survivors.
  
  
  METHODS
  The review was performed according to Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines, and the Cochrane Handbook for Systematic Reviews of Interventions. We performed a search of Medline (1946-2014), Embase (1980-2014), Cinahl (1981-2014), and PsycInfo (1806-2014) to identify studies that reported on the association between BMI and quality of life outcomes in endometrial cancer survivors.
  
  
  RESULTS
  Seven studies fulfilled the inclusion criteria, of which four studies could be included in the analysis. The four studies which included 1362 patients, showed that obese survivors had a significantly poorer physical functioning (P=0.001, MD: -11.61, 95% CI: -18.66 to -4.55), social functioning (P=0.01, MD: -4.37, 95% CI: -7.75 to -1.00) and role functioning (P=0.002, MD: -5.44 95% CI: -8.90 to -1.98) when compared to non-obese women. Emotional functioning and cognitive functioning did not show significant differences (P=0.18, P=0.21).
  
  
  CONCLUSIONS
  Obesity is associated with poorer quality of life outcomes in endometrial cancer survivors, including poorer physical, role and social functioning. Future research should be directed at lifestyle interventions aiming to enhance the quality of life of this group of survivors.
authors: Clinical Research Fellow, Royal Cornwall Hospital, Truro, UK.
authors: Anke
authors: A
authors: Smits
authors: Consultant Gynaecological Oncologist, Royal Cornwall Hospital, Truro, UK.
authors: Alberto
authors: A
authors: Lopes
authors: Associate Professor Obstetrics and Gynaecology, Radboud UMC, Nijmegen, The Netherlands.
authors: Ruud
authors: R
authors: Bekkers
authors: Consultant Gynaecological Oncologist, Royal Cornwall Hospital, Truro, UK. Electronic address: khadra.galaal@rcht.cornwall.nhs.uk.
authors: Khadra
authors: K
authors: Galaal
mesh_terms: D015992:Body Mass Index; D016889:Endometrial Neoplasms / Q000503:physiopathology* / Q000523:psychology; D005260:Female; D006801:Humans; D009765:Obesity / Q000503:physiopathology / Q000523:psychology; D011788:Quality of Life
keywords: Body mass index; Endometrial cancer; Quality of life; Survivorship