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Body mass index does not adversely affect survival from endometrial cancer
Acute myelosuppression was significantly less frequent among patients with higher BMI values.
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PALM SPRINGS, Calif. — Body mass index (BMI) is not predictive of progression-free or overall survival among patients with advanced or recurrent endometrial cancer treated with doxorubicin and cisplatin, according to a Gynecologic Oncology Group (GOG) study. In this study, 70% of the patient population was overweight or obese.
Treatment-related toxicity varied significantly by BMI, suggesting that further research is warranted to explore the effects of obesity on chemotherapy outcomes in this population, according to Susan Modesitt, MD, assistant professor of gynecologic oncology at the University of Kentucky. Modesitt presented her research here at the Society of Gynecologic Oncologists 37th Annual Meeting.
BMI categories
Modesitt and colleagues evaluated the association between BMI and treatment outcomes, including toxicity, progression-free survival and overall survival among women with advanced or recurrent endometrial cancer. All patients received chemotherapy with doxorubicin and cisplatin.
The researchers referred to data from cancer patients who participated in one of five randomized GOG trials: protocols 107, 122, 139, 163 and 177.
Following primary surgery and prior to chemotherapy, clinicians measured each patient’s weight and height to calculate their BMI. The researchers defined BMI values as normal (BMI<25), overweight (25<BMI<30) obese (30<BMI<40) and morbidly obese (BMI>40). They analyzed data for possible relationships among patient demographics, clinical characteristics, treatment-related toxicity, progression-free survival and overall survival.
Similar survival
There were 949 patients included in the GOG analysis. Of these patients, 56% had recurrent disease, 23.9% had stage IV disease and 19.9% had stage III disease. According to the analysis, 29.6% of patients were normal weight, 27% of patients were overweight, 33.2% of patients were obese and 10.2% of patients were morbidly obese. Overall, the median BMI was overweight (BMI 28.7).
The mean BMI was significantly different when the researchers compared age groups, disease stage, histologic type and tumor grade; older patients (P<.001), patients with clear-cell tumors (P=.047), patients with poorly differentiated tumors (P=.0234) and patients with stage IV disease (P=.014) presented with lower BMI values.
When adjusting for age, initial performance status, disease stage, histologic type, tumor grade and GOG study protocol, Modesitt and colleagues found no association between overall survival and BMI.
Grade-3 or -4 myelosuppression was significantly less frequent among patients with higher BMI, according to the study. However, patients with an elevated BMI (overweight, obese or morbidly obese) experienced more genitourinary adverse events than patients who were normal weight, Modesitt said. – by Rebekah Cintolo
For more information:
- Modesitt S, Tian C, Kryscio R, et al. Impact of body mass index on treatment outcomes in advanced or recurrent endometrial cancer patients receiving doxorubicin/cisplatin chemotherapy. Abstract 93. Presented at: Society of Gynecologic Oncologists 37th Annual Meeting; March 22-26, 2006; Palm Springs, Calif.