C M Nagle1, E J Crosbie2, A Brand3, A Obermair4, M K Oehler5, M Quinn6, Y Leung7, A B Spurdle8, P M Webb9. 1. Gynaecological Cancers Group, QIMR Berghofer Medical Research Institute, Brisbane, Australia; Faculty of Medicine, The University of Queensland, Herston Road, Brisbane, Queensland, Australia. Electronic address: christina.nagle@qimrberghofer.edu.au. 2. Gynaecological Oncology Research Group, Division of Cancer Sciences, University of Manchester, St Mary's Hospital, Oxford Road, Manchester, United Kingdom; Department of Obstetrics and Gynaecology, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, United Kingdom. 3. Westmead Hospital, Department of Gynaecologic Oncology, Sydney, Australia. 4. Faculty of Medicine, The University of Queensland, Herston Road, Brisbane, Queensland, Australia; Queensland Centre of Gynaecological Research, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia. 5. The University of Adelaide, School of Paediatrics and Reproductive Health, Adelaide, Australia. 6. Department of Obstetrics and Gynaecology, University of Melbourne, Parkville, Victoria, Australia. 7. Obstetrics and Gynaecology, The University of Western Australia, Crawley, Western Australia, Australia. 8. Molecular Cancer Epidemiology Group, QIMR Berghofer Medical Research Institute, Brisbane, Australia. 9. Gynaecological Cancers Group, QIMR Berghofer Medical Research Institute, Brisbane, Australia; Faculty of Medicine, The University of Queensland, Herston Road, Brisbane, Queensland, Australia.
Abstract
OBJECTIVE: Although endometrial cancer (EC) is associated with relatively good survival rates overall, women diagnosed with high-risk subtypes have poor outcomes. We examined the relationship between lifestyle factors and subsequent all-cause, cancer-specific and non-cancer related survival. METHODS: In a cohort of 1359 Australian women diagnosed with incident EC between 2005 and 2007 pre-diagnostic information was collected by interview at recruitment. Clinical and survival information was abstracted from women's medical records, supplemented by linkage to the Australian National Death Index. Cox proportional hazards regression was used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for all-cause and cause-specific survival (EC death vs. non-EC death) associated with each exposure, overall and by risk group (low-grade endometrioid vs. high-grade endometrioid and non-endometrioid). RESULTS: After a median follow-up of 7.1 years, 179 (13%) women had died, with 123 (69%) deaths from EC. As expected, elevated body mass index (BMI), diabetes and the presence of other co-morbidities were associated with a significantly increased risk of all-cause and non-cancer related death. Women with diabetes had higher cancer-specific mortality rates (HR 2.09, 95% CI 1.31-3.35), particularly those who had were not obese (HR 4.13, 95% CI 2.20-7.76). The presence of ≥2 other co-morbidities (excluding diabetes) was also associated with increased risk of cancer-specific mortality (HR 3.09, 95% CI 1.21-7.89). The patterns were generally similar for women with low-grade and high-grade endometrioid/non-endometrioid EC. CONCLUSION: Our findings demonstrate the importance of diabetes, other co-morbidities and obesity as negative predictors of mortality among women with EC but that the risks differ for cancer-specific and non-cancer related mortality.
OBJECTIVE: Although endometrial cancer (EC) is associated with relatively good survival rates overall, women diagnosed with high-risk subtypes have poor outcomes. We examined the relationship between lifestyle factors and subsequent all-cause, cancer-specific and non-cancer related survival. METHODS: In a cohort of 1359 Australian women diagnosed with incident EC between 2005 and 2007 pre-diagnostic information was collected by interview at recruitment. Clinical and survival information was abstracted from women's medical records, supplemented by linkage to the Australian National Death Index. Cox proportional hazards regression was used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for all-cause and cause-specific survival (EC death vs. non-EC death) associated with each exposure, overall and by risk group (low-grade endometrioid vs. high-grade endometrioid and non-endometrioid). RESULTS: After a median follow-up of 7.1 years, 179 (13%) women had died, with 123 (69%) deaths from EC. As expected, elevated body mass index (BMI), diabetes and the presence of other co-morbidities were associated with a significantly increased risk of all-cause and non-cancer related death. Women with diabetes had higher cancer-specific mortality rates (HR 2.09, 95% CI 1.31-3.35), particularly those who had were not obese (HR 4.13, 95% CI 2.20-7.76). The presence of ≥2 other co-morbidities (excluding diabetes) was also associated with increased risk of cancer-specific mortality (HR 3.09, 95% CI 1.21-7.89). The patterns were generally similar for women with low-grade and high-grade endometrioid/non-endometrioid EC. CONCLUSION: Our findings demonstrate the importance of diabetes, other co-morbidities and obesity as negative predictors of mortality among women with EC but that the risks differ for cancer-specific and non-cancer related mortality.
Authors: Renée L Kokts-Porietis; Jessica McNeil; Andria R Morielli; Linda S Cook; Kerry S Courneya; Christine M Friedenreich Journal: J Natl Cancer Inst Date: 2022-03-08 Impact factor: 11.816
Authors: Nicolae Bacalbasa; Camelia Diaconu; Laura Iliescu; Cornel Savu; Carmen Savu; Cristian Balalau; Mihai Dimitriu; Alexandru Filipescu; Ovidiu Gabriel Bratu; Adrian Neacsu; Dragos Cretoiu; Ioana Halmaciu; Irina Balescu Journal: In Vivo Date: 2020 Sep-Oct Impact factor: 2.155
Authors: Seungmin Kim; Jihye Park; Yuji Chen; Kerry Rowe; John Snyder; Alison Fraser; Ken Smith; Vikrant G Deshmukh; Michael Newman; Kimberley Herget; Christina A Porucznik; Dominik Ose; Mary Playdon; David Gaffney; Mia Hashibe Journal: Gynecol Oncol Date: 2019-12-12 Impact factor: 5.482
Authors: Elina Urpilainen; Anne Ahtikoski; Reetta Arima; Ulla Puistola; Peeter Karihtala Journal: Front Pharmacol Date: 2021-05-13 Impact factor: 5.810
Authors: Andreas Obermair; Eva Baxter; Donal J Brennan; Jessica N McAlpine; Jennifer J Muellerer; Frédéric Amant; Mignon D J M van Gent; Robert L Coleman; Shannon N Westin; Melinda S Yates; Camilla Krakstad; Monika Janda Journal: Obstet Gynecol Sci Date: 2020-07-08
Authors: Subhjit Sekhon; L Stewart Massad; Andrea R Hagemann; Rebecca Dick; Andrea Leon; Abigail S Zamorano; Premal H Thaker; Carolyn K McCourt; David G Mutch; Matthew A Powell; Lindsay M Kuroki Journal: Gynecol Oncol Rep Date: 2019-08-10