title: Survival outcomes of obese patients in type II endometrial cancer: Defining the prognostic impact of increasing BMI.
abstract: OBJECTIVE
  To investigate the role of obesity as a risk factor for type II endometrial cancer (EC), as well as the prognostic significance of increasing body mass index (BMI) on survival.
  
  
  METHODS
  A single institution retrospective analysis of 154 type II EC cases from 1987 to 2010 was conducted. Patients were categorized into cohorts by BMI (normal (<25), overweight (25-29.9), obese class I (30-34.9), and obese class II-III (≥35)). Descriptive, regression and ANOVA analyses were performed. Kaplan-Meier curves were compared with log rank tests.
  
  
  RESULTS
  The BMI distribution was 22.8% normal BMI; 24% overweight; 17.5% class I; and 35.7% class II-III. The median follow up was 41 months. The median progression-free survival (PFS) was 45.4, 36.0, 35.3 and 42.0 months and overall survival (OS) was 54.7, 44.7, 44.8 and 49.7 months, among the respective groups. There was no association between BMI and PFS (p=0.71), OS (p=0.72), or time to recurrence (p=0.71). There were no differences among the increasing BMI groups compared to normal weight women for the risk of death.
  
  
  CONCLUSIONS
  Our analysis did not reveal any differences in outcomes by BMI group. Our data reveals that obesity is highly prevalent in type II ECs, though obesity has not historically been described as a risk factor. While BMI as a single variable may not be prognostic for survival outcomes, the role of obesity as a risk factor for type II EC should be further investigated, given the increasing prevalence of obesity in type II ECs.
authors.affiliation: Department of Obstetrics and Gynecology, Division of Gynecology Oncology, The Ohio State University, College of Medicine, 320 W 10th Avenue, M210 Starling Loving, Columbus, OH 43210, United States. Electronic address: caroline.billingsley@uc.edu.
authors.forename: Caroline C
authors.initials: CC
authors.lastname: Billingsley
authors.affiliation: Department of Obstetrics and Gynecology, Division of Gynecologic Specialties, University of California, Davis, 4860 Y Street, Suite 2500, Sacramento, CA 95817, United States.
authors.forename: Catherine
authors.initials: C
authors.lastname: Cansino
authors.affiliation: Department of Obstetrics and Gynecology, Division of Gynecology Oncology, The Ohio State University, College of Medicine, 320 W 10th Avenue, M210 Starling Loving, Columbus, OH 43210, United States.
authors.forename: David M
authors.initials: DM
authors.lastname: O'Malley
authors.affiliation: Department of Obstetrics and Gynecology, Division of Gynecology Oncology, The Ohio State University, College of Medicine, 320 W 10th Avenue, M210 Starling Loving, Columbus, OH 43210, United States.
authors.forename: David E
authors.initials: DE
authors.lastname: Cohn
authors.affiliation: Department of Obstetrics and Gynecology, Division of Gynecology Oncology, The Ohio State University, College of Medicine, 320 W 10th Avenue, M210 Starling Loving, Columbus, OH 43210, United States.
authors.forename: Jeffrey M
authors.initials: JM
authors.lastname: Fowler
authors.affiliation: Department of Obstetrics and Gynecology, Division of Gynecology Oncology, The Ohio State University, College of Medicine, 320 W 10th Avenue, M210 Starling Loving, Columbus, OH 43210, United States.
authors.forename: Larry J
authors.initials: LJ
authors.lastname: Copeland
authors.affiliation: Department of Obstetrics and Gynecology, Division of Gynecology Oncology, The Ohio State University, College of Medicine, 320 W 10th Avenue, M210 Starling Loving, Columbus, OH 43210, United States.
authors.forename: Floor J
authors.initials: FJ
authors.lastname: Backes
authors.affiliation: Department of Obstetrics and Gynecology, Division of Gynecology Oncology, The Ohio State University, College of Medicine, 320 W 10th Avenue, M210 Starling Loving, Columbus, OH 43210, United States.
authors.forename: Ritu
authors.initials: R
authors.lastname: Salani
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D002277:Carcinoma / Q000150:complications / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D018572:Disease-Free Survival; D016889:Endometrial Neoplasms / Q000150:complications / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D009765:Obesity / Q000150:complications / Q000453:epidemiology*; D050177:Overweight / Q000150:complications / Q000453:epidemiology; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate
keywords: Endometrial cancer; Obesity; Survival outcomes; Type II