title: The effect of visceral obesity on clinicopathological features in patients with endometrial cancer: a retrospective analysis of 200 Chinese patients.
abstract: BACKGROUND
  To assess the effect of visceral adiposity on clinical and pathological characteristics in patients with endometrial cancer.
  
  
  METHODS
  A retrospective review of medical documentation was performed in surgically treated endometrial cancer patients from January to November 2015 in our institution. The visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) were measured at the level of umbilicus on single-slice computerized tomography. Visceral adiposity (VAT%) was calculated as VAT/(VAT + SAT).
  
  
  RESULTS
  A total of 200 cases were included in the study. Median age at diagnosis was 54 years old. Most patients presented with early-stage tumor (86.0% for I + II) and endometrioid histology (90.5%). Positive lymph node occurred in 11.0% (22/200) of the patients with the median number of retrieved nodes as 25 (range, 4-56). The entire population had a median body mass index (BMI) of 24.7 kg/m(2) and median VAT% of 31.89%. BMI correlated with total adipose tissue (correlation coefficient = 0.667, P < 0.001), but not with VAT% (P = 0.495). Viscerally obese patients tended to be old and post-menopausal (P < 0.001; P = 0.003). Nodal metastasis and extrauterine disease were more commonly reported in patients with high VAT% (6.0% vs. 16.0%, P = 0.024; 9.0% vs. 19.0%, P = 0.042, respectively). Univariate and multivariate logistic regressions were performed to discern the contribution of variable factors on the lymph node metastasis. Grade (HR = 15.41, 95% CI = 1.60-148.76; P = 0.018), lympho-vascular invasion (HR = 449.61, 95% CI = 31.27-6463.93; P < 0.001) and high VAT% (HR = 6.37, 95% CI = 1.42-28.69; P = 0.016) retained statistical significance for predicting lymph node metastasis.
  
  
  CONCLUSIONS
  Viscerally obese patients were more likely to be old and have positive lymph node as well as extrauterine disease. Grade, lympho-vascular invasion presence and visceral adiposity were predictors of nodal disease.
authors.affiliation: Department of Gynecologic Oncology, Fudan University Shanghai Cancer Center, Shanghai, China.|Department of Oncology, Shanghai Medical College, Fudan University, No 270 Dong-an Road, Xuhui District, 200032, Shanghai, China.
authors.forename: Shuang
authors.initials: S
authors.lastname: Ye
authors.affiliation: Department of Gynecologic Oncology, Fudan University Shanghai Cancer Center, Shanghai, China.|Department of Oncology, Shanghai Medical College, Fudan University, No 270 Dong-an Road, Xuhui District, 200032, Shanghai, China.
authors.forename: Hao
authors.initials: H
authors.lastname: Wen
authors.affiliation: Department of Oncology, Shanghai Medical College, Fudan University, No 270 Dong-an Road, Xuhui District, 200032, Shanghai, China.|Department of Radiology, Fudan University Shanghai Cancer Center, Shanghai, China.
authors.forename: Zhaoxia
authors.initials: Z
authors.lastname: Jiang
authors.affiliation: Department of Gynecologic Oncology, Fudan University Shanghai Cancer Center, Shanghai, China. docwuxh@hotmail.com.|Department of Oncology, Shanghai Medical College, Fudan University, No 270 Dong-an Road, Xuhui District, 200032, Shanghai, China. docwuxh@hotmail.com.
authors.forename: Xiaohua
authors.initials: X
authors.lastname: Wu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044466:Asian People; D015992:Body Mass Index; D016889:Endometrial Neoplasms / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000473:pathology*; D005260:Female; D006801:Humans; D050152:Intra-Abdominal Fat / Q000000981:diagnostic imaging / Q000473:pathology*; D016015:Logistic Models; D008207:Lymphatic Metastasis / Q000473:pathology; D008875:Middle Aged; D056128:Obesity, Abdominal / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000473:pathology*; D012307:Risk Factors; D050151:Subcutaneous Fat / Q000000981:diagnostic imaging / Q000473:pathology*; D014057:Tomography, X-Ray Computed
keywords: Body mass index; Clinicopathological features; Endometrial cancer; Lymph node metastasis; Visceral adiposity