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Ali MM, Parveen S, Williams V, Dons R, Uwaifo GI. Cardiometabolic comorbidities and complications of obesity and chronic kidney disease (CKD). J Clin Transl Endocrinol 2024; 36:100341. [PMID: 38616864 PMCID: PMC11015524 DOI: 10.1016/j.jcte.2024.100341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Revised: 03/28/2024] [Accepted: 03/29/2024] [Indexed: 04/16/2024] Open
Abstract
Obesity and chronic kidney disease are two ongoing progressive clinical pandemics of major public health and clinical care significance. Because of their growing prevalence, chronic indolent course and consequent complications both these conditions place significant burden on the health care delivery system especially in developed countries like the United States. Beyond the chance coexistence of both of these conditions in the same patient based on high prevalence it is now apparent that obesity is associated with and likely has a direct causal role in the onset, progression and severity of chronic kidney disease. The causes and underlying pathophysiology of this are myriad, complicated and multi-faceted. In this review, continuing the theme of this special edition of the journal on " The Cross roads between Endocrinology and Nephrology" we review the epidemiology of obesity related chronic kidney disease (ORCKD), and its various underlying causes and pathophysiology. In addition, we delve into the consequent comorbidities and complications associated with ORCKD with particular emphasis on the cardio metabolic consequences and then review the current body of evidence for available strategies for chronic kidney disease modulation in ORCKD as well as the potential unique role of weight reduction and management strategies in its improvement and risk reduction.
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Affiliation(s)
- Mariam M. Ali
- Southern Illinois School of Medicine, Department of Medicine, Section of Endocrinology, Diabetes and Metabolism, 751 North Rutledge Street, Moy Building, Suite 1700, Springfield, Il 62702, United States
| | - Sanober Parveen
- Southern Illinois School of Medicine, Department of Medicine, Section of Endocrinology, Diabetes and Metabolism, 751 North Rutledge Street, Moy Building, Suite 1700, Springfield, Il 62702, United States
| | - Vanessa Williams
- Southern Illinois School of Medicine, Department of Medicine, Section of Endocrinology, Diabetes and Metabolism, 751 North Rutledge Street, Moy Building, Suite 1700, Springfield, Il 62702, United States
| | - Robert Dons
- Southern Illinois School of Medicine, Department of Medicine, Section of Endocrinology, Diabetes and Metabolism, 751 North Rutledge Street, Moy Building, Suite 1700, Springfield, Il 62702, United States
| | - Gabriel I. Uwaifo
- Section of Endocrinology, Dept of Medicine, SIU School of Medicine, 751 N Rutledge St, Moy Building, Suite 1700, Room #1813, Springfield, Il 62702, United States
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Long L, He X, Liu Y, Lei C. Effect of two different modalities of hysterectomy on wound infection and wound dehiscence in obese patients. Int Wound J 2024; 21:e14664. [PMID: 38439170 PMCID: PMC10912368 DOI: 10.1111/iwj.14664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2023] [Accepted: 12/29/2023] [Indexed: 03/06/2024] Open
Abstract
This research intended to investigate the influence of the operation of both kinds of hysterectomies in the risk of wound infection and the degree of wound dehiscence. Both of them were open field and laparoscope. In this research, we looked into four databases: PubMed, Web of Science, Embase and Cochrane Library. Research was conducted on various operative methods for hysterectomy in obese patients between 2000 and October 2023. Two independent investigators performed an independent review of the data, established the inclusion and exclusion criteria, and managed the results with Endnote software. It also evaluated the quality of the included literature. Finally, the data were analysed with RevMan 5.3. This study involved 874 cases, 387 cases received laparoscopy and 487 cases received open access operation. Our findings indicate that there is a significant reduction in the rate of post-operative wound infection among those who have received laparoscopy compared with who have received open surgical procedures (odds ratio [OR], 0.04; 95% confidence interval [CI], 0.01-0.15; p < 0.001); There was no statistical difference between the rate of post-operative wound dehiscence and those who received laparotomy compared with those who received open surgical procedures (OR, 0.33; 95% CI, 0.10-1.11; p = 0.07); The estimated amount of blood lost during the operation was less in the laparoscopy group compared with the open procedure (mean difference, -123.72; 95% CI, -215.16 to -32.28; p = 0.008). Generally speaking, the application of laparoscopy to overweight women who have had a hysterectomy results in a reduction in the expected amount of bleeding during surgery and a reduction in the risk of post-operative wound infections.
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Affiliation(s)
- Ling Long
- Department of Gynecological OncologyChongqing University Cancer Hospital, Chongqing Cancer Institute, Chongqing Cancer HospitalChongqingChina
| | - Xuan He
- Department of Cancer Center, Daping HospitalArmy Medical University (Third Military Medical University)ChongqingChina
| | - Yuyang Liu
- Department of Traditional Chinese Medicine, College of MedicineChangchun University of Traditional Chinese MedicineChongqingChina
| | - Cuirong Lei
- Department of Gynecological OncologyChongqing University Cancer Hospital, Chongqing Cancer Institute, Chongqing Cancer HospitalChongqingChina
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Johnson CR, Liao CI, Tian C, Richardson MT, Duong K, Tran N, Winkler SS, Kapp DS, Darcy K, Chan JK. Uterine cancer among Asian Americans - Disparities & clinical characteristics. Gynecol Oncol 2024; 182:24-31. [PMID: 38246043 DOI: 10.1016/j.ygyno.2023.12.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 12/19/2023] [Accepted: 12/22/2023] [Indexed: 01/23/2024]
Abstract
OBJECTIVE To evaluate the patterns and trends of uterine cancer among Asian subgroups living in the U.S. METHODS Data were obtained from United States Cancer Statistics (2001-2017), National Cancer Database (2004-2015), and World Population Review (2023). SEER*Stat version 8.3.9.2, Joinpoint regression program 4.9.0.0, and SAS v 9.4 were employed for statistical analysis. RESULTS Based on data from 778,891 women in the United States Cancer Statistics database, Asians had a 3.4-fold higher rate of incident uterine cancer compared to White populations (2.14% vs. 0.63%; p < 0.001). Using the National Cancer Database, 7,641 Asian women from six subgroups were analyzed: Filipino, Korean, Indian/Pakistani, Vietnamese, Chinese, and Japanese. Indian and Pakistani women had the greatest increase in the proportion of cancer diagnoses (5.0% to 14.4%; p = 0.0003). Additionally, Indian and Pakistani patients had higher comorbidity scores while Koreans had the lowest (22.7% vs. 10.7%, p < 0.0001). Regarding stage of disease, 25.3% of Filipinos presented with advanced stage disease compared to 19.2% of Indians and Pakistanis (p = 0.0001). Furthermore, Filipinos had the highest proportion of non-endometrioid cancers at 18.4% compared to other subgroups (p = 0.0003). Using the World Population Review, female obesity was highest in Pakistan (8.6%) and the Philippines (7.5%) and lowest in Vietnam (2.6%). CONCLUSION Uterine cancer incidence increased at higher rates among Asians compared to White populations. Specifically, Indian and Pakistani uterine cancer patients were more likely to have higher comorbidity rates and Filipino patients had more advanced stage cancer with non-endometrioid histologies than other Asian subgroups. Further research is warranted to better understand these trends.
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Affiliation(s)
- Caitlin R Johnson
- California Pacific Medical Center Research Institute, 1100 Van Ness, San Francisco, CA 94109, USA.
| | - Cheng-I Liao
- Pingtung Veterans General Hospital, Department of Obstetrics and Gynecology, Pingtung, Taiwan
| | - Chunqiao Tian
- Gynecologic Cancer Center of Excellence Program, Henry M Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD, USA
| | - Michael T Richardson
- University of California, Los Angeles, Department of Obstetrics and Gynecology, 757 Westwood Blvd, Los Angeles, CA, USA
| | - Kim Duong
- Western University of Health Sciences, College of Osteopathic Medicine, 309 E 2nd St, Pomona, CA 91766, USA
| | - Nathan Tran
- California Pacific Medical Center Research Institute, 1100 Van Ness, San Francisco, CA 94109, USA
| | - Stuart S Winkler
- Brooke Army Medical Center, Department of Obstetrics and Gynecology, 3551 Roger Brooke Dr., Fort Sam Houston, TX, United States of America
| | - Daniel S Kapp
- Stanford University School of Medicine, Department of Radiation Oncology, 875 Blake Wilbur Dr, Stanford, CA 94304, USA
| | - Kathleen Darcy
- Gynecologic Cancer Center of Excellence Program, Henry M Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD, USA
| | - John K Chan
- California Pacific Medical Center Research Institute, 1100 Van Ness, San Francisco, CA 94109, USA
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Lechartier C, Bernard J, Renaud MC, Plante M. Robotic-assisted surgery for endometrial cancer is safe in morbidly and extremely morbidly obese patients. Gynecol Oncol 2023; 172:15-20. [PMID: 36905768 DOI: 10.1016/j.ygyno.2023.02.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Revised: 02/19/2023] [Accepted: 02/24/2023] [Indexed: 03/12/2023]
Abstract
OBJECTIVE Obesity has risen to affect >25% of the Canadian population. Perioperative challenges with increased morbidity are encountered. We evaluated the outcome of robotic-assisted surgery for endometrial cancer (EC) in obese patients. METHODS We retrospectively reviewed all robotic surgeries performed for EC in women with BMI ≥40 kg/m2, from 2012 to 2020 in our center. Patients were divided into 2 groups (class III: 40-49 kg/m2, class IV: ≥50 kg/m2). Complications and outcome were compared. RESULTS 185 patients were included: 139 class III and 46 class IV. The main histology was endometrioid adenocarcinoma (70,5% of class III and 58,1% of class IV (p = 0,138)). The mean blood loss, overall sentinel node detection and median length of stay were similar in both groups. Six class III (4,3%) and 3 class IV (6,5%) patients required conversion to laparotomy due to poor surgical field exposure (p = 0,692). The rate of intraoperative complications was similar between the 2 groups (1.4% in class III vs none in class IV, p = 1). There were 10 class III (7,2%) and 10 class IV (21,7%) post-operative complications (p = 0.011), but most were grade 2 (3,6% in class III vs 13% in class IV, p = 0.029)). Grade 3 and 4 postoperative complications were low (2.7%) and not statistically different between the 2 groups. Readmission rate was low in both groups (4 in each group, p = 1.07). Recurrence occurred in 5,8% of class III and 4,3% of class IV patients (p = 1). CONCLUSION Robotic-assisted surgery for EC in class III and class IV obese patients is a safe and feasible procedure, with low complication rate, similar oncologic outcome, conversion rate, blood loss, readmission rate and length of hospital stay.
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Affiliation(s)
- Céline Lechartier
- Gynecologic Oncology Division, L'Hôtel-Dieu de Québec, Centre Hospitalier Universitaire de Québec, Laval University, Quebec City, Canada.
| | - Juliette Bernard
- Gynecologic Oncology Division, L'Hôtel-Dieu de Québec, Centre Hospitalier Universitaire de Québec, Laval University, Quebec City, Canada
| | - Marie-Claude Renaud
- Gynecologic Oncology Division, L'Hôtel-Dieu de Québec, Centre Hospitalier Universitaire de Québec, Laval University, Quebec City, Canada
| | - Marie Plante
- Gynecologic Oncology Division, L'Hôtel-Dieu de Québec, Centre Hospitalier Universitaire de Québec, Laval University, Quebec City, Canada.
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Simon O, Dion L, Nyangoh Timoh K, Dupré PF, Azaïs H, Bendifallah S, Touboul C, Dabi Y, Graesslin O, Raimond E, Costaz H, Kerbage Y, Huchon C, Mimoun C, Koskas M, Akladios C, Lecointre L, Canlorbe G, Chauvet P, Ouldamer L, Levêque J, Lavoué V. Impact of severe obesity in the management of patients with high-risk endometrial cancer: A FRANCOGYN study. J Gynecol Obstet Hum Reprod 2022; 51:102429. [DOI: 10.1016/j.jogoh.2022.102429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Revised: 05/29/2022] [Accepted: 06/09/2022] [Indexed: 10/18/2022]
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Iyoshi S, Sumi A, Yoshihara M, Kitami K, Mogi K, Uno K, Fujimoto H, Miyamoto E, Tano S, Yoshikawa N, Emoto R, Matsui S, Kajiyama H. Obesity contributes to the stealth peritoneal dissemination of ovarian cancer: a multi-institutional retrospective cohort study. Obesity (Silver Spring) 2022; 30:1599-1607. [PMID: 35851756 DOI: 10.1002/oby.23497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Revised: 04/06/2022] [Accepted: 04/28/2022] [Indexed: 11/08/2022]
Abstract
OBJECTIVE The clinical significance of a higher BMI on the prognosis of ovarian cancer remains controversial; therefore, a more detailed analysis is demanded. This study investigated the impact of BMI on peritoneum-specific recurrence to clarify the involvement of adipose tissue in the proliferation of cancer cells at sites of peritoneal dissemination. METHODS Among 4,730 patients with malignant ovarian tumors, 280 diagnosed with International Federation of Gynecology and Obstetrics (FIGO) stage IIB to IIIC epithelial ovarian cancer and who underwent complete resection in the primary surgery were included in the present study. RESULTS There were 42, 201, and 37 women in the low, normal, and high BMI groups, respectively. Peritoneum-specific recurrence-free survival and overall survival were both significantly shorter in patients with a high BMI than in those with a normal BMI (p = 0.028 and 0.018, respectively). No significant differences were observed in the distribution of sites of recurrence between these two groups. A multivariate analysis identified obesity as an independent prognostic factor in addition to pT3 tumor staging and positive ascites cytology. CONCLUSIONS Patients with a high BMI had a significantly worse prognosis than those with a normal BMI, and peritoneal adipose tissue may have contributed to this difference.
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Affiliation(s)
- Shohei Iyoshi
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, Japan
- Spemann Graduate School of Biology and Medicine, University of Freiburg, Freiburg, Germany
| | - Asami Sumi
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, Japan
- Department of Obstetrics and Gynecology, Tosei General Hospital, Seto, Japan
| | - Masato Yoshihara
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Kazuhisa Kitami
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, Japan
- Department of Obstetrics and Gynecology, Kitasato University School of Medicine, Sagamihara, Japan
| | - Kazumasa Mogi
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Kaname Uno
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, Japan
- Division of Clinical Genetics, Department of Laboratory Medicine, Lund University Graduate School of Medicine, Lund, Sweden
| | - Hiroki Fujimoto
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, Japan
- Discipline of Obstetrics and Gynaecology, Adelaide Medical School, Robinson Research Institute, University of Adelaide, Adelaide, South Australia, Australia
| | - Emiri Miyamoto
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Sho Tano
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Nobuhisa Yoshikawa
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Ryo Emoto
- Department of Biostatistics, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Shigeyuki Matsui
- Department of Biostatistics, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Hiroaki Kajiyama
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, Japan
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Pantelimon I, Gales LN, Anghel RM, Gruia MI, Nita I, Matei CV, Bodea D, Stancu AM, Pirvu E, Radu MC, Dumitrescu AI, Manolescu LSC. Aspects Regarding the Influence of Obesity on the Molecular Characteristics of Breast Tumors. Cureus 2022; 14:e26952. [PMID: 35989732 PMCID: PMC9381069 DOI: 10.7759/cureus.26952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/17/2022] [Indexed: 11/05/2022] Open
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Sultana S, Bouyahya A, Rebezov M, Shariati MA, Balahbib A, Khouchlaa A, El Yaagoubi OM, Khaliq A, Omari NE, Bakrim S, Zengin G, Akram M, Khayrullin M, Bogonosova I, Mahmud S, Simal-Gandara J. Impacts of nutritive and bioactive compounds on cancer development and therapy. Crit Rev Food Sci Nutr 2022; 63:9187-9216. [PMID: 35416738 DOI: 10.1080/10408398.2022.2062699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
For persons who survive with progressive cancer, nutritional therapy and exercise may be significant factors to improve the health condition and life quality of cancer patients. Nutritional therapy and medications are essential to managing progressive cancer. Cancer survivors, as well as cancer patients, are mostly extremely encouraged to search for knowledge about the selection of diet, exercise, and dietary supplements to recover as well as maintain their treatment consequences, living quality, and survival of patients. A healthy diet plays an important role in cancer treatment. Different articles are studied to collect information and knowledge about the use of nutrients in cancer treatment as well as cancer prevention. The report deliberates nutrition and exercise strategies during the range of cancer care, emphasizing significant concerns during treatment of cancer and for patients of advanced cancer, but concentrating mostly on the requirements of the population of persons who are healthy or who have constant disease following their repossession from management. It also deliberates choice nutrition and exercise problems such as dietary supplements, food care, food selections, and weight; problems interrelated to designated cancer sites, and common questions about diet, and cancer survival. Decrease the side effects of medicines both during and after treatment.
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Affiliation(s)
- Sabira Sultana
- Department of Eastern Medicine, Government College University Faisalabad, Pakistan
| | - Abdelhakim Bouyahya
- Laboratory of Human Pathology Biology, Faculty of Sciences, and Genomic Center of Human Pathology, Mohammed V University, Rabat, Morocco
| | - Maksim Rebezov
- V M Gorbatov Federal Research Center for Food Systems of Russian Academy of Sciences, Moscow, Russian Federation
- K.G. Razumovsky Moscow State University of Technologies and Management (The First Cossack University), Moscow, Russian Federation
| | - Mohammad Ali Shariati
- K.G. Razumovsky Moscow State University of Technologies and Management (The First Cossack University), Moscow, Russian Federation
| | - Abdelaali Balahbib
- Laboratory of Biodiversity, Ecology, and Genome, Faculty of Sciences, Mohammed V University, Rabat, Morocco
| | - Aya Khouchlaa
- Laboratory of Human Pathology Biology, Faculty of Sciences, and Genomic Center of Human Pathology, Mohammed V University, Rabat, Morocco
| | - Ouadie Mohamed El Yaagoubi
- Laboratory of Biochemistry, Environment and Agri-Food (URAC 36) - Faculty of Sciences and Techniques - Mohammedia, Hassan II University Casablanca - Morocco
| | - Adnan Khaliq
- Department of Food Science and Technology, Khwaja Fareed University of Engineering and Information Technology, Pakistan
| | - Nasreddine El Omari
- Laboratory of Histology, Embryology, and Cytogenetic, Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco
| | - Saad Bakrim
- Molecular Engineering, Valorization and Environment Team, Polydisciplinary Faculty of Taroudant, Ibn Zohr University, Agadir, Morocco
| | - Gokhan Zengin
- Department of Biology, Science Faculty, Selcuk University, Konya, Turkey
| | - Muhammad Akram
- Department of Eastern Medicine, Government College University Faisalabad, Pakistan
| | - Mars Khayrullin
- K.G. Razumovsky Moscow State University of Technologies and Management (The First Cossack University), Moscow, Russian Federation
| | - Irina Bogonosova
- K.G. Razumovsky Moscow State University of Technologies and Management (The First Cossack University), Moscow, Russian Federation
| | - Shafi Mahmud
- Genetic Engineering and Biotechnology, University of Rajshahi, Rajshahi, Bangladesh
| | - Jesus Simal-Gandara
- Department of Analytical Chemistry and Food Science, Faculty of Science, Universidade de Vigo, Nutrition and Bromatology Group, Ourense, Spain
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Prodromidou A, Koulakmanidis AM, Haidopoulos D, Nelson G, Rodolakis A, Thomakos N. Where Enhanced Recovery after Surgery (ERAS) Protocols Meet the Three Major Current Pandemics: COVID-19, Obesity and Malignancy. Cancers (Basel) 2022; 14:cancers14071660. [PMID: 35406432 PMCID: PMC8996966 DOI: 10.3390/cancers14071660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Revised: 03/18/2022] [Accepted: 03/21/2022] [Indexed: 01/27/2023] Open
Abstract
Simple Summary The SARS-CoV-2 (COVID-19) pandemic has significantly modified the medical services provided for patients that receive care either for COVID-19 or for those that need care for benign diseases, including obesity, or for malignant ones, such as gynecological cancer. We sought to investigate the association among three major worldwide health issues (COVID-19, obesity, and malignancy) and how ERAS protocols can potentially provide optimal management of patients with obesity and malignancy during the COVID-19 pandemic, with special attention to patients who required surgery for gynecologic oncology. We strongly believe that the application of ERAS protocols could play a key role during these unprecedented COVID-19 times. Abstract The outbreak of the SARS-CoV-2 (COVID-19) pandemic has transformed the provision of medical services for both patients that receive care for COVID-19 and for those that need care either for benign diseases, including obesity, or for malignancies, such as gynecological cancer. In this perspective article, we focus on the association among three major worldwide health issues and how ERAS protocols can potentially provide optimal management of patients with obesity and malignancy during the COVID-19 pandemic, with special attention to patients who required surgery for gynecologic oncology. A thorough search of the literature on the respective topics was performed. Patients with malignancy and obesity presented with increased vulnerability to COVID-19 infection. However, the management of their disease should not be withheld. Protective measures should be established to reduce exposure of patients with oncological diseases to SARS-CoV-2 while simultaneously enabling their access to vaccination. Since ERAS protocols have proved to be efficient in many surgical fields, including gynecologic oncology, general surgery, and orthopedics, we strongly believe that ERAS protocols may play a significant role in this effort. The end of the COVID-19 pandemic cannot be accurately predicted. Nevertheless, we have to ensure the appropriate and efficient management of certain groups of patients.
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Affiliation(s)
- Anastasia Prodromidou
- Gynaecologic Oncology Unit, 1st Department of Obstetrics and Gynaecology, Alexandra Hospital, National and Kapodistrian University of Athens, 11528 Athens, Greece; (A.-M.K.); (D.H.); (A.R.); (N.T.)
- Correspondence: ; Tel.: +30-6972751000
| | - Aristotelis-Marios Koulakmanidis
- Gynaecologic Oncology Unit, 1st Department of Obstetrics and Gynaecology, Alexandra Hospital, National and Kapodistrian University of Athens, 11528 Athens, Greece; (A.-M.K.); (D.H.); (A.R.); (N.T.)
| | - Dimitrios Haidopoulos
- Gynaecologic Oncology Unit, 1st Department of Obstetrics and Gynaecology, Alexandra Hospital, National and Kapodistrian University of Athens, 11528 Athens, Greece; (A.-M.K.); (D.H.); (A.R.); (N.T.)
| | - Gregg Nelson
- Department of Obstetrics and Gynecology, University of Calgary, Calgary, AB T2N 1N4, Canada;
| | - Alexandros Rodolakis
- Gynaecologic Oncology Unit, 1st Department of Obstetrics and Gynaecology, Alexandra Hospital, National and Kapodistrian University of Athens, 11528 Athens, Greece; (A.-M.K.); (D.H.); (A.R.); (N.T.)
| | - Nikolaos Thomakos
- Gynaecologic Oncology Unit, 1st Department of Obstetrics and Gynaecology, Alexandra Hospital, National and Kapodistrian University of Athens, 11528 Athens, Greece; (A.-M.K.); (D.H.); (A.R.); (N.T.)
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Zare-Bidaki M, Zardast M, Nadjafi-Semnani A, Nadjafi-Semnani M, Javanmard D, Ghafari S, Ghanbarzadeh N. Investigation of frequency and typing of human papillomavirus among genital warts using a reverse dot blot hybridization approach. BMC Infect Dis 2022; 22:278. [PMID: 35317740 PMCID: PMC8941769 DOI: 10.1186/s12879-022-07276-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2021] [Accepted: 03/15/2022] [Indexed: 12/24/2022] Open
Abstract
Background Human papillomavirus (HPV) is the most common sexually transmitted infection worldwide, affecting about 80% of women up to the age of 50. The persistent infection of high risk-HPV types (HR-HPV) is the leading cause of cervical cancer, the fourth most common cancer of women. Therefore, we aimed to evaluate the frequency and typing of HPV in the genital lesions in the Iranian population. Methods This descriptive-analytic study was conducted on a population in the South-Khorasan province of Iran. All of the participants were sexually active and were checked for evident cervical warts. Biopsy samples were collected from various lesions, and all samples were tested for detection and genotyping of HPV using a reverse dot blot hybridization method (HPV direct flow CHIP). Results In overall, 370 samples were evaluated; 10 cases (2.7%) were male and the rest were female. The mean age of patients was 33.3 ± 8.5 years, of which 48.1% were in the age range from 25 to 36 years. Among the samples, 345 (93.2%) were positive for HPV-DNA; the low risk HPV types (LR-HPV) and HR-HPV were identified among 80.9% and 15.5% of tissue samples, respectively. Among the LR-HPV, HPV-6, 11, 42 and 54 were the most common genotypes, and HPV-16 and 39 were prevalent HR-HPV types detected. The number of pregnancies, marriage age, and partner infection were not significantly related to the HPV types. Types 42 had a declining pattern toward aging, and HPV-11 was increasing toward aging. Conclusion The number of samples with HR-HPV was rather high. Due to the greater frequency of infection in the age range of 25–35 years, it is advised that all individuals referred to gynecological clinics at gestational age be tested for HPV types.
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Affiliation(s)
- Majid Zare-Bidaki
- Infectious Diseases Research Center, Birjand University of Medical Sciences, Birjand, Iran.,Department of Medical Microbiology, Faculty of Medicine, Birjand University of Medical Sciences, Birjand, Iran
| | - Mahmoud Zardast
- Deprtment of Pathology, Birjand University of Medical Sciences, Birjand, Iran
| | - Ali Nadjafi-Semnani
- Department of General Surgery, Zahedan University of Medical Sciences, Zahedan, Iran
| | | | - Davod Javanmard
- Infectious Diseases Research Center, Birjand University of Medical Sciences, Birjand, Iran.,Department of Medical Microbiology, Faculty of Medicine, Birjand University of Medical Sciences, Birjand, Iran
| | - Shokouh Ghafari
- Infectious Diseases Research Center, Birjand University of Medical Sciences, Birjand, Iran
| | - Nahid Ghanbarzadeh
- Department of Gynecology and Obstetrics, Medical Faculty, Birjand University of Medical Sciences, Birjand, Iran.
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Overview of the Composition of Whole Grains’ Phenolic Acids and Dietary Fibre and Their Effect on Chronic Non-Communicable Diseases. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19053042. [PMID: 35270737 PMCID: PMC8910396 DOI: 10.3390/ijerph19053042] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 02/22/2022] [Accepted: 02/26/2022] [Indexed: 02/01/2023]
Abstract
Chronic non-communicable diseases are the major cause of death globally. Whole grains are recommended in dietary guidelines worldwide due to increasing evidence that their consumption can improve health beyond just providing energy and nutrients. Epidemiological studies have suggested that the incorporation of whole grains, as part of a healthy diet, plays a key role in reducing one’s risk for cardiovascular diseases (CVDs), obesity, type 2 diabetes (T2D) and cancer. Phenolic acids and dietary fibre are important components found in whole grains that are largely responsible for these health advantages. Both phenolic acids and dietary fibre, which are predominantly present in the bran layer, are abundant in whole-grain cereals and pseudo-cereals. Several studies indicate that whole grain dietary fibre and phenolic acids are linked to health regulation. The main focus of this study is two-fold. First, we provide an overview of phenolic acids and dietary fibres found in whole grains (wheat, barley, oats, rice and buckwheat). Second, we review existing literature on the linkages between the consumption of whole grains and the development of the following chronic non-communicable diseases: CVDs, obesity, T2D and cancer. Altogether, scientific evidence that the intake of whole grains reduces the risk of certain chronic non-communicable disease is encouraging but not convincing. Based on previous studies, the current review encourages further research to cover the gap between the emerging science of whole grains and human health.
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Yan YS, Qu Z, Lv PP, Huang HF. Pediatric and adult obesity concerns in female health: a Mendelian randomization study. Endocrine 2022; 75:400-408. [PMID: 34542801 DOI: 10.1007/s12020-021-02867-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Accepted: 09/03/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE Adulthood and childhood obesity are both associated with reproductive diseases and gynecological cancers in females. However, the causal factors associated with these observations have yet to be identified. Mendelian randomization is a process that is independent of inverse bias and confounding and can act as a random control trial in which genetic groups are settled during meiosis, thus representing an effective tool with which to investigate causality. METHODS We carried out several Mendelian randomization trials based on the combined genetic scores of 75 adult-associated and 15 childhood-associated body mass index (BMI) single nucleotide polymorphisms (SNPs), databases for several gynecological cancers and reproductive diseases from the UK Biobank (with 194,153 participants), using the traditional inverse-variance weighted (IVW) method as the main method. RESULTS Elevated adult-associated BMI scores (odds ratio [OR] = 1.003; 95% confidence interval [CI]: 1.001-1.004) and childhood-associated BMI scores (OR = 1.003; 95% CI: 1.001-1.004) were related to a higher risk of the polycystic ovarian syndrome (PCOS), as determined by the traditional IVW method. The random IVW method further revealed a nominal negative causal association between childhood-associated BMI and subsequent endometriosis (OR = 0.995; 95% CI: 0.991-0.999). CONCLUSIONS Consistent with observational consequences, our findings indicated that adulthood obesity may play role in the development of PCOS and that childhood obesity can increase the risk of PCOS but may reduce the incidence of endometriosis in later life. Further research is now needed to validate our findings and identify the precise mechanisms involved.
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Affiliation(s)
- Yi-Shang Yan
- The Key Laboratory of Reproductive Genetics (Zhejiang University), Ministry of Education, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
- Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Zihao Qu
- Department of Orthopedic Surgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310009, Zhejiang, China
- Orthopedic Research Institute of Zhejiang University, Hangzhou, 310009, Zhejiang, China
| | - Ping-Ping Lv
- The Key Laboratory of Reproductive Genetics (Zhejiang University), Ministry of Education, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
- Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - He-Feng Huang
- The Key Laboratory of Reproductive Genetics (Zhejiang University), Ministry of Education, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
- Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
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Yu Z, Wei S, Zhang J, Shi R, An L, Feng D, Wang H. Development and Validation of a Novel Prognostic Model for Endometrial Cancer Based on Clinical Characteristics. Cancer Manag Res 2021; 13:8879-8886. [PMID: 34866940 PMCID: PMC8637423 DOI: 10.2147/cmar.s338861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Accepted: 11/17/2021] [Indexed: 12/09/2022] Open
Abstract
Objective Existing prognostic models for endometrial cancer are short of facility and effective validation. In this study, we aim to develop and validate a novel prognostic model for endometrial cancer based on clinical characteristics. Methods The clinical data such as age, BMI (body mass index), FIGO stage, surgical approach, myometrial invasion, grade, lymph node metastasis, pathology and menopause status were collected for constructing and validating the prognostic model from The Cancer Genome Atlas (TCGA) and Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, respectively. COX regression and the least absolute shrinkage and selection operator (LASSO) COX were applied to identify the significant predictors of overall survival (OS) and construct the prognostic model. The discrimination, calibration, and clinical usefulness of the model were evaluated in both cohorts. Results Three hundred and sixty-seven and 286 EC patients were collected for training and validation cohort, respectively. A clinical prognostic model integrating six clinical variables including age, BMI, FIGO stage, surgical approach, myometrial invasion and grade was established. K-M analysis shows a significant difference between the low- and high-risk groups. The area under the receiver operating characteristic curve (AUC-ROC) was 0.775 (95% CI, 0.708 to 0.843) and 0.870 (95% CI, 0.758 to 0.982) for the training and validation cohorts which indicating reliable discrimination. The calibration curve revealed excellent predictive accuracy and the Hosmer–Lemeshow test also verified this. Decision curve analysis (DCA) for the prognostic model indicated that it would add more benefits than either the detect-all-patients scheme or the detect-none scheme. In addition, our model has a superior AUC comparing with any single factor as predicting OS. Conclusion Our predictive model offers a convenient and accurate tool for clinicians to estimate the prognosis of EC patients.
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Affiliation(s)
- Zhicheng Yu
- Department of Obstetrics and Gynecology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of China
| | - Sitian Wei
- Department of Obstetrics and Gynecology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of China
| | - Jun Zhang
- Department of Obstetrics and Gynecology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of China
| | - Rui Shi
- Department of Obstetrics and Gynecology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of China
| | - Lanfen An
- Department of Obstetrics and Gynecology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of China
| | - Dilu Feng
- Department of Obstetrics and Gynecology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of China
| | - Hongbo Wang
- Department of Obstetrics and Gynecology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of China
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López-Ozuna VM, Kogan L, Hachim MY, Matanes E, Hachim IY, Mitric C, Kiow LLC, Lau S, Salvador S, Yasmeen A, Gotlieb WH. Identification of Predictive Biomarkers for Lymph Node Involvement in Obese Women With Endometrial Cancer. Front Oncol 2021; 11:695404. [PMID: 34307159 PMCID: PMC8292832 DOI: 10.3389/fonc.2021.695404] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 06/23/2021] [Indexed: 11/13/2022] Open
Abstract
Obesity, an established risk factor for endometrial cancer (EC), is also associated to increased risks of intraoperative and postoperative complications. A reliable tool to identify patients at low risk for lymph node (LN) metastasis may allow minimizing the surgical staging and omit lymphadenectomy in obese patients. To identify molecular biomarkers that could predict LN involvement in obese patients with EC we performed gene expression analysis in 549 EC patients using publicly available transcriptomic datasets. Patients were filtrated according to cancer subtype, weight (>30 kg/m2) and LN status. While in the LN+ group, NEB, ANK1, AMIGO2, LZTS1, FKBP5, CHGA, USP32P1, CLIC6, CEMIP, HMCN1 and TNFRSF10C genes were highly expressed; in the LN- group CXCL14, FCN1, EPHX3, DDX11L2, TMEM254, RNF207, LTK, RPL36A, HGAL, B4GALNT4, KLRG1 genes were up-regulated. As a second step, we investigated these genes in our patient cohort of 35 patients (15 LN+ and 20 LN-) and found the same correlation with the in-silico analysis. In addition, immunohistochemical expression was confirmed in the tumor tissue. Altogether, our findings propose a novel panel of genes able to predict LN involvement in obese patients with endometrial cancer.
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Affiliation(s)
- Vanessa M López-Ozuna
- Division of Gynecologic Oncology, Jewish General Hospital, McGill University, Montreal, QC, Canada.,Segal Cancer Center, Lady Davis Institute of Medical Research, McGill University, Montreal, QC, Canada
| | - Liron Kogan
- Division of Gynecologic Oncology, Jewish General Hospital, McGill University, Montreal, QC, Canada.,Department of Gynecologic Oncology, Hadassah Medical Center, affiliated with Hebrew University Hadassah Medical School, Jerusalem, Israel
| | - Mahmood Y Hachim
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | - Emad Matanes
- Division of Gynecologic Oncology, Jewish General Hospital, McGill University, Montreal, QC, Canada.,Segal Cancer Center, Lady Davis Institute of Medical Research, McGill University, Montreal, QC, Canada
| | - Ibrahim Y Hachim
- College of Medicine, Sharjah Institute for Medical Research, University of Sharjah, Sharjah, United Arab Emirates
| | - Cristina Mitric
- Division of Gynecologic Oncology, Jewish General Hospital, McGill University, Montreal, QC, Canada.,Segal Cancer Center, Lady Davis Institute of Medical Research, McGill University, Montreal, QC, Canada
| | - Lauren Liu Chen Kiow
- Division of Gynecologic Oncology, Jewish General Hospital, McGill University, Montreal, QC, Canada.,Segal Cancer Center, Lady Davis Institute of Medical Research, McGill University, Montreal, QC, Canada
| | - Susie Lau
- Division of Gynecologic Oncology, Jewish General Hospital, McGill University, Montreal, QC, Canada.,Segal Cancer Center, Lady Davis Institute of Medical Research, McGill University, Montreal, QC, Canada
| | - Shannon Salvador
- Division of Gynecologic Oncology, Jewish General Hospital, McGill University, Montreal, QC, Canada.,Segal Cancer Center, Lady Davis Institute of Medical Research, McGill University, Montreal, QC, Canada
| | - Amber Yasmeen
- Division of Gynecologic Oncology, Jewish General Hospital, McGill University, Montreal, QC, Canada.,Segal Cancer Center, Lady Davis Institute of Medical Research, McGill University, Montreal, QC, Canada
| | - Walter H Gotlieb
- Division of Gynecologic Oncology, Jewish General Hospital, McGill University, Montreal, QC, Canada.,Segal Cancer Center, Lady Davis Institute of Medical Research, McGill University, Montreal, QC, Canada
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Lorenzo PM, Crujeiras AB. Potential effects of nutrition-based weight loss therapies in reversing obesity-related breast cancer epigenetic marks. Food Funct 2021; 12:1402-1414. [PMID: 33480953 DOI: 10.1039/d0fo01984d] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Obesity is a modifiable risk factor of breast cancer and epigenetic marks were proposed as a relevant mechanistic link. These mechanisms can be remodelled by modifying lifestyle factors and this fact could be useful in the treatment of obesity-related breast cancer. This review aimed to reveal the current evidence on the effects of differences in body composition and lifestyle factors on the risk, treatment, and survival of breast cancer with a focus on the effects of weight loss therapies based on different nutrients, bioactive compounds, and Mediterranean and ketogenic diets to counteract obesity-related breast cancer epigenetic marks. This review was framed on the most relevant and recently published articles and abstracts selected in PubMed using key words related to epigenetics, lifestyle, dietary habits, nutrients, bioactive compounds, ketone bodies, and weight loss treatments in obesity and breast cancer. Several studies have demonstrated that lifestyle interventions, including dietary modifications towards a healthy diet pattern, are effective therapies to prevent the onset of breast cancer and to improve the survival after treatment. These therapies reduce the main factors associated with obesity that are links between adiposity and cancer, including oxidative stress, inflammation and epigenetic mechanisms. However, although sufficient evidence exists regarding the effects of nutrients, dietary patterns, and weight loss therapies to prevent breast cancer or to improve survival, the effects of these strategies on the oncological treatment response were less studied. This review summarises the current scientific evidence regarding these nutritional strategies as adjuvant therapies in the management of obesity-related breast cancer by remodelling epigenetic marks related to carcinogenesis.
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Affiliation(s)
- Paula M Lorenzo
- Epigenomics in Endocrinology and Nutrition Group, Instituto de Investigacion Sanitaria (IDIS), Complejo Hospitalario Universitario de Santiago (CHUS/SERGAS), Santiago de Compostela, Spain.
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Kölbl H, Bartl T. Obesity in Gynecologic Oncology. Geburtshilfe Frauenheilkd 2020; 80:1205-1211. [PMID: 33293728 PMCID: PMC7714555 DOI: 10.1055/a-1124-7139] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 07/25/2020] [Indexed: 12/31/2022] Open
Abstract
The decades-long global obesity epidemic has resulted in steady increase in the incidence of obesity-related malignancies. The associated diagnostic and therapeutic implications present a clinical challenge for gynecologic oncology treatment strategies. Recent studies have provided solid evidence for an independent, linear, positive correlation between a pathologically increased body mass index and the probability of developing endometrial or postmenopausal breast cancer. The pathogenesis is complex and the subject of current research. Proposed causes include pathologically increased serum levels of sexual steroids and adiponectin, obesity-induced insulin resistance, and systemic inflammatory processes. The scientific evidence for an association between obesity and other gynecological malignancies is, however, less solid. The clinical relevance of obesity as a risk factor for epithelial ovarian cancer, cervical cancer and vulvar cancer appears to be negligible.
Nevertheless, obesity appears to have a negative impact on prognosis and oncologic outcomes for all gynecological cancers. Whether or not this effect can be interpreted as correlative or causal is still a subject of ongoing debate.
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Affiliation(s)
- Heinz Kölbl
- Klinische Abteilung für Allgemeine Gynäkologie und Gynäkologische Onkologie, Universitätsklinik für Frauenheilkunde, Medizinische Universität Wien, Wien, Austria
| | - Thomas Bartl
- Klinische Abteilung für Allgemeine Gynäkologie und Gynäkologische Onkologie, Universitätsklinik für Frauenheilkunde, Medizinische Universität Wien, Wien, Austria
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Simpson AN, Sutradhar R, Ferguson SE, Robertson D, Cheng SY, Baxter NN. Class III Obesity and Other Factors Associated with Longer Wait Times for Endometrial Cancer Surgery: A Population-Based Study. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2020; 42:1093-1102.e3. [DOI: 10.1016/j.jogc.2020.03.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Revised: 03/04/2020] [Accepted: 03/07/2020] [Indexed: 11/30/2022]
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Tsui ST, Yang J, Zhang X, Spaniolas K, Kim S, Griffin T, Burke WM, Pryor AD. The risk of female-specific cancer after bariatric surgery in the state of New York. Surg Endosc 2020; 35:4267-4274. [PMID: 32851468 DOI: 10.1007/s00464-020-07915-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 08/17/2020] [Indexed: 11/24/2022]
Abstract
BACKGROUND Obesity is a known risk factor for many cancers. Although bariatric surgery has been associated with a decrease in the risk of developing cancer, data on the effect of bariatric surgery on female-specific cancers are limited. This study aimed to assess the impact of bariatric interventions on the development of endometrial, ovarian and breast cancer. METHODS The New York Statewide Planning and Research Cooperative System database was used to identify all female patients without a pre-existing cancer diagnosis who had a diagnosis of obesity between 2006 and 2012. The risk of having female-specific cancer diagnosis in patients who underwent bariatric surgery were compared with those who had no bariatric interventions using multivariable proportional sub-distribution hazard regression analysis. Subsequent cancer diagnoses were followed up to 2016. RESULTS We identified 55,781 and 247,102 obese female patients who had and did not have bariatric surgery, respectively. The overall incidence of female-specific cancer was 2.69% and 2.09% for the non-surgery and surgery groups, respectively (p < 0.0001). Surgery patients were less likely to develop female-specific cancers [hazard ratio (HR) 0.78; 95% CI 0.73-0.83; p < 0.0001]. Patients undergoing Roux-en-Y gastric bypass had a lower risk of developing female-specific cancer than laparoscopic sleeve gastrectomy (HR 0.66; 95% CI 0.51-0.87; p = 0.0056) and laparoscopic adjustable gastric banding (HR 0.83; 95% CI 0.69-0.99; p = 0.0056) patients. CONCLUSIONS Patients undergoing bariatric surgery have a lower incidence of endometrial, female breast and ovarian cancer than non-surgery obese patients. These data suggest that bariatric interventions may reduce the risk of female-specific cancers.
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Affiliation(s)
- Stella T Tsui
- Division of Bariatric, Foregut and Advanced Gastrointestinal Surgery, Department of Surgery, Stony Brook University Medical Center, Stony Brook, NY, USA.
- Stony Brook University Medical Center, 101 Nicolls Rd, Health Science Center, T-19, Room 053, Stony Brook, USA.
| | - Jie Yang
- Department of Family, Population and Preventive Medicine, Stony Brook University Medical Center, Stony Brook, NY, USA
| | - Xiaoyue Zhang
- Department of Family, Population and Preventive Medicine, Stony Brook University Medical Center, Stony Brook, NY, USA
| | - Konstantinos Spaniolas
- Division of Bariatric, Foregut and Advanced Gastrointestinal Surgery, Department of Surgery, Stony Brook University Medical Center, Stony Brook, NY, USA
| | - Sara Kim
- Department of Obstetrics, Gynecology and Reproductive Medicine, Stony Brook University Medical Center, Stony Brook, NY, USA
| | - Todd Griffin
- Department of Obstetrics, Gynecology and Reproductive Medicine, Stony Brook University Medical Center, Stony Brook, NY, USA
| | - William M Burke
- Department of Obstetrics, Gynecology and Reproductive Medicine, Stony Brook University Medical Center, Stony Brook, NY, USA
| | - Aurora D Pryor
- Division of Bariatric, Foregut and Advanced Gastrointestinal Surgery, Department of Surgery, Stony Brook University Medical Center, Stony Brook, NY, USA
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Simpson AN, Sutradhar R, Ferguson SE, Robertson D, Cheng SY, Li Q, Baxter NN. Perioperative outcomes of women with and without class III obesity undergoing hysterectomy for endometrioid endometrial cancer: A population-based study. Gynecol Oncol 2020; 158:681-688. [PMID: 32571681 DOI: 10.1016/j.ygyno.2020.06.480] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 06/04/2020] [Indexed: 01/25/2023]
Abstract
OBJECTIVE Population-based data on perioperative complications among women with endometrial cancer and severe obesity are lacking. We evaluated 30-day complication rates among women with and without class III obesity (body mass index ≥ 40 kg/m2) undergoing primary surgical management for endometrioid endometrial cancer (EEC), and how outcomes differed according to surgical approach (open vs. minimally invasive). METHODS We performed a retrospective population-based cohort study of women with EEC undergoing hysterectomy in Ontario, Canada, between 2006 and 2015. We evaluated perioperative complications in the whole cohort, and in a 1:1 matched analysis using hard and propensity score matching to ensure similar distributions of patient, tumour, provider and institution-level factors between women with and without class III obesity (identified using a surgical billing code). The primary outcome of interest was the 30-day perioperative complication rate. RESULTS 12,112 women met inclusion criteria; 2697 (22.3%) had class III obesity. We matched 2320 (86%) women with class III obesity to those without. The composite complication rate was significantly higher among women with class III obesity (23.2% vs. 18.4%, standardized mean difference [SMD] = 0.12), primarily due to wound infection/disruption (12.1% vs. 6.2%). There was no difference in outcomes for women with and without class III obesity when a minimally invasive approach was used. CONCLUSIONS Wound infection/disruption was increased for women with class III obesity compared to women without. Otherwise, perioperative complications were similar between the matched pairs. When minimally invasive approaches were used, women with class III obesity had a similar risk of complications as women without obesity.
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Affiliation(s)
- A N Simpson
- Department of Obstetrics and Gynecology, St. Michael's Hospital/Unity Health Toronto, Toronto, ON, Canada; Department of Obstetrics and Gynecology, University of Toronto, Toronto, ON, Canada; Institute of Health Policy, Management, and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada; Li Ka Shing Knowledge Institute, St. Michael's Hospital/Unity Health Toronto, Toronto, ON, Canada.
| | - R Sutradhar
- Institute of Health Policy, Management, and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada; ICES, Toronto, ON, Canada
| | - S E Ferguson
- Department of Obstetrics and Gynecology, University of Toronto, Toronto, ON, Canada; Division of Gynecologic Oncology, University Health Network/Mount Health Systems, Toronto, ON, Canada
| | - D Robertson
- Department of Obstetrics and Gynecology, St. Michael's Hospital/Unity Health Toronto, Toronto, ON, Canada; Department of Obstetrics and Gynecology, University of Toronto, Toronto, ON, Canada; Institute of Health Policy, Management, and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | | | - Q Li
- ICES, Toronto, ON, Canada
| | - N N Baxter
- Institute of Health Policy, Management, and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada; ICES, Toronto, ON, Canada; Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
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The risk of developing breast, ovarian, and endometrial cancer in obese women submitted to bariatric surgery: a meta-analysis. Surg Obes Relat Dis 2020; 16:1596-1602. [PMID: 32690459 DOI: 10.1016/j.soard.2020.06.008] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Revised: 06/01/2020] [Accepted: 06/02/2020] [Indexed: 12/14/2022]
Abstract
This article performs a systematic review and meta-analysis to investigate the impact of bariatric surgery and the risk of developing breast, ovarian, and endometrial cancer in obese women. MEDLINE, EMBASE, LILACS, and Cochrane databases were searched from inception until January 2019 to retrieve studies that assessed the risk of breast, ovarian, or endometrial cancer in obese women submitted to bariatric surgery. There was no language restriction. We extracted and combined data from studies to assess the risk ratio (RR) of developing these neoplasms. A random-effects meta-analytic model was applied in all calculations. The New Castle Ottawa and GRADE were used to assess quality of the included studies and certainty of the evidence, respectively. This study is registered in PROSPERO (CRD42019112927). We found 188 articles and 7 of those were included in our meta-analysis, which incorporated a total of 150,537 patients in the bariatric surgery arm and 1,461,938 women in the control arm. The total RR of breast, ovarian, and endometrial cancer was .41 (95% confidence interval [CI]: .31-.56]; I2 = 90%; 7 studies). The risk of breast cancer was reduced by 49% (RR: .51; 95%CI: .31-.83]; I2 = 92%; 6 studies). The risk of ovarian cancer was reduced by 53% (RR: .47; 95%CI: .27-81; I2 = 0%; 3 studies). The risk of endometrial cancer was reduced by 67% (RR: .33; 95%CI: .21-.51; I2 = 88%; 7 studies). Bariatric surgery may have a protective effect reducing the risk of breast, ovarian, and endometrial cancer in obese women. The high heterogeneity and other issues justify the need for further studies to deepen our knowledge.
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Okoro SO, Ajah LO, Nkwo PO, Aniebue UU, Ozumba BC, Chigbu CO. Association between obesity and abnormal Papanicolau(Pap) smear cytology results in a resource-poor Nigerian setting. BMC WOMENS HEALTH 2020; 20:119. [PMID: 32517800 PMCID: PMC7285436 DOI: 10.1186/s12905-020-00984-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/30/2019] [Accepted: 06/02/2020] [Indexed: 12/05/2022]
Abstract
Background Though obesity is associated with some malignancies, its association with cervical cancer is still inconclusive. This study was aimed at determining if there was an association between obesity and cervical epithelial cell abnormalities (CEA). Methods This was a cross-sectional comparative study of obese and non-obese women at the Cervical Cancer Screening Clinic, University of Nigeria Teaching Hospital (UNTH), Enugu between January, 2012 and June, 2013. The participants whose body mass index (BMI) were ≥ 30 kg/m2 were classified as obese (200 women) while those whose BMI were < 30 kg/m2 were classified as non-obese (200 women) and the two groups were consecutively recruited at the ratio of 1:1. Pap smear cytology, random blood sugar (RBS) and human immune-deficiency virus (HIV) screening was done for all the participants. Data was analyzed with SPSS version 20. Categorical variables were analyzed using McNemar’s test and Chi-squared test. Logistic regression analysis was used to determine the influence of socio-demographic characteristics on cervical epithelial cell abnormalities. The level of significance was set at ≤0.05. Results Among the obese women, 152(76%) had negative for intra-epithelial lesion or malignancy (NILM) while 48(24%) had cervical epithelial cell abnormalities (CEA). Also 182(91%) non-obese women had NILM while the remaining 18(9%) had CEA. The prevalence of CEA among all the study participants was 16.5%. There was an association between obesity and CEA[OR (95%CI) = 1.353(1.013–1.812); P-value = 0.04].CEA were significantly more common among women who were 40 years and above and single/separated women as well as widows (P-value = < 0.05). Conclusion There was an association between obesity and CEA. This underscores the need for a positive behavioural change among women in order to stem the tide of this public health problem.
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Affiliation(s)
- Silas Onyemaechi Okoro
- Department of Obstetrics and Gynaecology, Faculty of Medical Sciences, University of Nigeria, Ituku-Ozalla Campus, Enugu, Nigeria
| | - Leonard Ogbonna Ajah
- Department of Obstetrics and Gynaecology, Faculty of Medical Sciences, University of Nigeria, Ituku-Ozalla Campus, Enugu, Nigeria.
| | - Peter Onubiwe Nkwo
- Department of Obstetrics and Gynaecology, Faculty of Medical Sciences, University of Nigeria, Ituku-Ozalla Campus, Enugu, Nigeria
| | - Uzochukwu U Aniebue
- Department of Obstetrics and Gynaecology, Faculty of Medical Sciences, University of Nigeria, Ituku-Ozalla Campus, Enugu, Nigeria
| | - Benjamin Chukwuma Ozumba
- Department of Obstetrics and Gynaecology, Faculty of Medical Sciences, University of Nigeria, Ituku-Ozalla Campus, Enugu, Nigeria
| | - Chibuike Ogwuegbu Chigbu
- Department of Obstetrics and Gynaecology, Faculty of Medical Sciences, University of Nigeria, Ituku-Ozalla Campus, Enugu, Nigeria
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Cusimano MC, Simpson AN, Han A, Hayeems R, Bernardini MQ, Robertson D, Kives SL, Satkunaratnam A, Baxter NN, Ferguson SE. Barriers to care for women with low-grade endometrial cancer and morbid obesity: a qualitative study. BMJ Open 2019; 9:e026872. [PMID: 31248922 PMCID: PMC6597640 DOI: 10.1136/bmjopen-2018-026872] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVE Obesity is a major risk factor for low-grade endometrial cancer. The surgical management of patients with obesity is challenging, and they may face unique barriers to accessing care. We completed a qualitative study to understand the experiences of low-grade endometrial cancer patients with morbid obesity, from symptom onset to diagnosis to surgery. DESIGN Semi-structured interviews were performed with endometrial cancer patients with morbid obesity (body mass index (BMI) >40 kg/m2) referred for primary surgery. Transcribed interviews were coded line-by-line and analysed using an interpretive descriptive approach that drew on labelling theory to understand patients' experiences. Thematic sufficiency was confirmed after 15 interviews. SETTING Two tertiary care centres in Toronto, Ontario, Canada. PARTICIPANTS Fifteen endometrial cancer patients with a median age of 61 years (range: 50-74) and a median BMI of 50 kg/m2 (range: 44-70) were interviewed. RESULTS Thematic analysis identified that (1) both patients and providers lack knowledge on endometrial cancer and its presenting symptoms and risk factors; (2) patients with morbid obesity are subject to stigma and poor communication in the healthcare system and (3, 4) although clinical, administrative, financial, geographic and facility-related barriers exist, quality care for patients with morbid obesity is an achievable goal. CONCLUSIONS Improved education on the prevention and identification of endometrial cancer is needed for both patients and providers. Delivery of cancer care to patients with morbid obesity may be improved through provider awareness of the impact of weight stigma and establishing streamlined care pathways at centres equipped to manage surgical complexity.
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Affiliation(s)
- Maria C Cusimano
- Obstetrics and Gynaecology, University of Toronto, Toronto, Ontario, Canada
| | - Andrea N Simpson
- Obstetrics and Gynaecology, University of Toronto, Toronto, Ontario, Canada
- Obstetrics and Gynaecology, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Angela Han
- Obstetrics and Gynaecology, University of Toronto, Toronto, Ontario, Canada
| | - Robin Hayeems
- Child Health Evaluative Sciences, Hospital for Sick Children, Toronto, Ontario, Canada
- Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Marcus Q Bernardini
- Obstetrics and Gynaecology, University of Toronto, Toronto, Ontario, Canada
- Gynaecology Oncology, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Deborah Robertson
- Obstetrics and Gynaecology, University of Toronto, Toronto, Ontario, Canada
- Obstetrics and Gynaecology, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Sari L Kives
- Obstetrics and Gynaecology, University of Toronto, Toronto, Ontario, Canada
- Obstetrics and Gynaecology, St. Michael's Hospital, Toronto, Ontario, Canada
| | | | - Nancy N Baxter
- Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Ontario, Canada
- General Surgery, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Sarah E Ferguson
- Obstetrics and Gynaecology, University of Toronto, Toronto, Ontario, Canada
- Gynaecology Oncology, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
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Dilator Use After Vaginal Brachytherapy for Endometrial Cancer: A Randomized Feasibility and Adherence Study. Cancer Nurs 2019; 41:200-209. [PMID: 28437283 DOI: 10.1097/ncc.0000000000000500] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Vaginal brachytherapy, a common treatment of endometrial cancer, is associated with high rates of vaginal stenosis. Recommendations for vaginal dilator use to minimize stenosis generally include 3 times per week for approximately 10 minutes per use. However, adherence rates range widely and are generally well less than 50%. OBJECTIVES The aims of this study were to assess feasibility of recruitment to a study of dilator use and test a theoretically driven enhanced educational program (EEP) to increase adherence. METHODS Eligibility included women treated with postoperative vaginal brachytherapy for stage I to IIIc endometrial cancer. Patients were randomized to either nurse-delivered standard institutional instruction or EEP. RESULTS Of eligible patients, 76% consented, 42 were randomized, and 69% completed the 6-month assessment. Mean age was 58.2 years; 48% were sexually active. There was no difference in adherence between arms. Overall, 20% and 8.3% were adherent to the prescribed use of 3 times per week, and 64% and 16% were adherent to use at least once per week at 6 weeks and 6 months, respectively. Adherence was greater among those motivated by vaginal health and having lower body mass index. Nonadherence was significantly higher among those who are college educated, in the EEP group, and with higher weight. CONCLUSIONS Feasibility of recruitment into a study of vaginal dilator use was high. Adherence was low, and there was no difference between groups. Adherence to vaginal dilator use requires novel interventions to test. IMPLICATIONS FOR PRACTICE Nursing education that includes how dilators may maintain vaginal health may improve use because it was a motivator for adherence in this study.
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Casadio P, Guasina F, Talamo MR, Paradisi R, Morra C, Magnarelli G, Seracchioli R. Conservative hysteroscopic treatment of stage I well differentiated endometrial cancer in patients with high surgical risk: a pilot study. J Gynecol Oncol 2019; 30:e62. [PMID: 31074243 PMCID: PMC6543116 DOI: 10.3802/jgo.2019.30.e62] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Revised: 01/24/2019] [Accepted: 02/04/2019] [Indexed: 12/13/2022] Open
Abstract
Objective To report hysteroscopic treatment combined with levonorgestrel-releasing intrauterine device (LNG-IUD) to treat women with early well differentiated endometrial cancer (EC) at high surgical risk. Methods Nine women diagnosed with stage IA, grade 1 endometrioid EC which was contraindicated or refused standard treatment with external beam radiation therapy with or without brachytherapy were enrolled in our prospective study. Endo-myometrial hysteroscopic resection of the whole uterine cavity and the placement of LNG-IUD for 5 years was performed. Response rate, perioperative complications, and recurrence of disease were evaluated. Results None had intra or post-operative complications and all were discharged no later than the third day of hospitalization. After 6 months from surgery, all the women showed a complete regression of the lesion. All the women completed the 5 years follow-up and in no case was detected sign of recurrence. Two women died for causes unrelated to the tumor or the ongoing therapy. Conclusion The alternative treatment with endo-myometrial hysteroscopic resection and LNG-IUD in women with stage IA, grade 1 endometrioid EC showed initial encouraging outcomes in terms of effectiveness and safety.
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Affiliation(s)
- Paolo Casadio
- Department of Obstetrics, Gynecology and Reproductive Biology, DIMEC, S.Orsola Hospital, University Alma Mater Studiorum of Bologna, Bologna, Italy
| | - Francesca Guasina
- Department of Gynecology and Obstetrics, Santa Chiara Regional Hospital, Trento, Italy
| | - Maria Rita Talamo
- Department of Obstetrics, Gynecology and Reproductive Biology, DIMEC, S.Orsola Hospital, University Alma Mater Studiorum of Bologna, Bologna, Italy.
| | - Roberto Paradisi
- Department of Obstetrics, Gynecology and Reproductive Biology, DIMEC, S.Orsola Hospital, University Alma Mater Studiorum of Bologna, Bologna, Italy
| | - Ciro Morra
- Department of Obstetrics, Gynecology and Reproductive Biology, DIMEC, S.Orsola Hospital, University Alma Mater Studiorum of Bologna, Bologna, Italy
| | - Giulia Magnarelli
- Department of Obstetrics, Gynecology and Reproductive Biology, DIMEC, S.Orsola Hospital, University Alma Mater Studiorum of Bologna, Bologna, Italy
| | - Renato Seracchioli
- Department of Obstetrics, Gynecology and Reproductive Biology, DIMEC, S.Orsola Hospital, University Alma Mater Studiorum of Bologna, Bologna, Italy
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Stricklin D, Prins R, Bellman J. Development of age-dependent dose modification factors for acute radiation lethality. Int J Radiat Biol 2019; 96:67-80. [DOI: 10.1080/09553002.2018.1547438] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Affiliation(s)
| | - Robert Prins
- Applied Research Associates, Inc., Arlington, VA, USA
| | - Jacob Bellman
- Applied Research Associates, Inc., Arlington, VA, USA
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26
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Planque H, Martin-Françoise S, Lequesne J, Le Brun JF. [Robotic surgery in endometrial cancer: Feasibility in obese patients]. ACTA ACUST UNITED AC 2018; 46:625-631. [PMID: 30115552 DOI: 10.1016/j.gofs.2018.07.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Indexed: 10/28/2022]
Abstract
OBJECTIVE Minimally invasive surgery is a technique frequently used in gynecologic surgery. The robot-assisted surgery is a recent approach, and the benefits are not yet proven. The objective of this study was to evaluate the feasibility to use robot-assisted surgery for obese patient with endometrial cancer. METHODS All patients undergoing a robotic surgery for uterus malignant indication between March 2013 and May 2016 in our center were retrospectively included. Patients were divided in two groups, according to their body mass index (BMI). The group with BMI<30kg/m2 was the reference for this comparative study. The main criteria was the robot operative time. The other criteria were total operating time, hospital stay and intraoperative and postoperative complications. RESULTS Seventy-seven patients met inclusion criteria for analysis. The median robot operative time was 110minutes for all patients [21-341], without difference between the five groups (P=0.60). There was no difference for the total operative time (P=0.50). The median hospital stay was 3 days (P=0.92). There were ten intraoperative complications. One patient had a conversion (1.3%). There was no statistical difference for postoperative complications (P=1). CONCLUSION Our study found few differences in the surgical management by laparoscopic robot-assisted between obese and non obese women. Robot-assisted surgery seems to be feasible for uterine cancer treatment of obese patients. Prospective and randomized studies are needed to assess the benefit of the robotic surgery.
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Affiliation(s)
- H Planque
- Service de chirurgie cancérologique, centre de lutte contre le cancer François-Baclesse, 3, avenue du Général-Harris, 14000 Caen, France.
| | - S Martin-Françoise
- Service de chirurgie cancérologique, centre de lutte contre le cancer François-Baclesse, 3, avenue du Général-Harris, 14000 Caen, France.
| | - J Lequesne
- Service de recherche clinique, centre de lutte contre le cancer François-Baclesse, 3, avenue du Général-Harris, 14000 Caen, France.
| | - J F Le Brun
- Service de chirurgie cancérologique, centre de lutte contre le cancer François-Baclesse, 3, avenue du Général-Harris, 14000 Caen, France.
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Temkin SM, Rimel BJ, Bruegl AS, Gunderson CC, Beavis AL, Doll KM. A contemporary framework of health equity applied to gynecologic cancer care: A Society of Gynecologic Oncology evidenced-based review. Gynecol Oncol 2018; 149:70-77. [PMID: 29605053 DOI: 10.1016/j.ygyno.2017.11.013] [Citation(s) in RCA: 52] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Revised: 10/19/2017] [Accepted: 11/07/2017] [Indexed: 01/21/2023]
Abstract
Health disparities are defined as the preventable difference in the burden of disease, injury, and violence, or opportunity to achieve optimal health that socially disadvantaged populations experience compared to the population as a whole. Disparities in incidence and cancer outcomes for women with gynecologic malignancies have been well described particularly for American women of Black race. The etiology of these disparities has been tied to socio-economics, cultural, educational and genetic factors. While access to high quality treatment has been primarily linked to survival from cervical and ovarian cancer, innate biologic distinctions have been principally cited as reasons for differences in incidence and mortality in cancers of the uterine corpus. This article will update the framework of disparities to incorporate a broader understanding of the social determinants of health and how they affect health equity by addressing the root causes of disparities within the health care system. Special populations are identified who are at risk for health inequities which include but are not limited to Black race, underserved racial and ethnic minorities (e.g. indigenous peoples, low English fluency), trans/gender nonconforming people and rural populations. Each of these populations at risk have unique structural barriers within the healthcare system impacting gynecologic cancer outcomes. The authors provide practical recommendations for practitioners aimed at eliminating cancer related outcome disparities.
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Affiliation(s)
- Sarah M Temkin
- Virginia Commonwealth University, Massey Cancer Center, Richmond, VA, USA
| | - B J Rimel
- Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | | | - Camille C Gunderson
- Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma city, OK, USA
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Arem H, Loftfield E. Cancer Epidemiology: A Survey of Modifiable Risk Factors for Prevention and Survivorship. Am J Lifestyle Med 2018; 12:200-210. [PMID: 30202392 PMCID: PMC6124966 DOI: 10.1177/1559827617700600] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2016] [Revised: 02/03/2017] [Accepted: 03/01/2017] [Indexed: 12/14/2022] Open
Abstract
Approximately 40% of men and women in the United States will be diagnosed with cancer at some point in their lives. There have been dramatic developments in our understanding of cancer development and progression in recent decades, leading to improvements in screening and treatment, and in turn greater numbers of survivors living longer after diagnosis. Epidemiologic evidence of lifestyle-related factors and cancer risk and survival has been explored extensively in the published literature, with recommendations for cancer prevention and control and strategies for implementation evolving over time. This review summarizes the burden of cancer, general measurement issues in cancer epidemiology, and the current state of the science in specific lifestyle-related risk factors and cancer. It is estimated that one third to one half of cancers could be prevented by healthier lifestyle choices.
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Affiliation(s)
- Hannah Arem
- Hannah Arem, PhD, Department of Epidemiology and Biostatistics, Milken Institute School of Public Health, George Washington University, 950 New Hampshire Avenue NW, Office 514, Washington, DC 20052; e-mail:
| | - Erikka Loftfield
- Department of Epidemiology and Biostatistics, Milken Institute School of Public Health, George Washington University, Washington, DC (HA)
- Division of Cancer Epidemiology and Genetics, Metabolic Epidemiology Branch, National Cancer Institute, Rockville, Maryland (EL)
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Peri- and postoperative management and outcomes of morbidly obese patients (BMI > 40 kg/m2) with gynaecological disease. Arch Gynecol Obstet 2018. [DOI: 10.1007/s00404-018-4735-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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30
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Chen Y, Zhang L, Liu W, Wang K. Case-control study of metabolic syndrome and ovarian cancer in Chinese population. Nutr Metab (Lond) 2017; 14:21. [PMID: 28261315 PMCID: PMC5330115 DOI: 10.1186/s12986-017-0176-4] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2016] [Accepted: 02/17/2017] [Indexed: 12/25/2022] Open
Abstract
Background Recent studies have proved metabolic syndrome (MetS) was linked to cancer risks. However, few data has examined the relationship between MetS and epithelial ovarian cancer (EOC). Methods We conducted a population-based case-control study in Tianjin Medical University Cancer Institute and Hospital, China (2010–2015) that enrolled 573 EOC patients and 1146 matched controls. Data were collected through in-person interviews, anthropometric measurement, and 8-h fasting bloods drawn. MetS was estimated by Chinese Diabetes Society (CDS) definition requiring presence of ≥3 of the following risk factors: 1) body mass index (BMI) ≥25.0 kg/m2,2) fasting plasma glucose ≥6.1 mmol/L or 2-h plasma glucose ≥ 7.8 mmol/L, 3) systolic blood pressure ≥140 mmHg or diastolic blood pressure ≥90 mmHg, 4) triglyceride (TG) ≥1.70 mmol/L or high-density lipoprotein cholesterol (HDL-C) < 1.0 mmol/L. Statistics were completed using chi-square tests and logistic regression analysis. The survival analysis was conducted by the Kaplan-Meier method and Cox proportional hazard regression models. Results MetS was significantly more prevalent among EOC (25.13%) than controls (6.89%). A statistically significant increase risk for EOC was observed for MetS (multivariable-adjusted OR = 3.187; 95% CI: 2.135–4.756). MetS was significantly associated with histological grade (P < 0.001), FIGO stage (P = 0.003), and lymph node (LN) status (P = 0.002) of EOC. In binary logistic regression analysis, the presence of MetS predicts the risk of advanced FIGO stage (OR = 2.155, 95% CI: 1.327–3.498, P = 0.002), lower differentiation (OR = 2.472, 95% CI: 1.164–5.250, P = 0.019), and LN metastasis (OR = 2.590, 95% CI: 1.089–6.160, P = 0.031) of EOC. Moreover, MetS is the independent factor for the evaluation of PFS and OS of EOC patients (both of them P < 0.001) in Cox proportional hazard model. Conclusion MetS is obviously related to increased EOC risk. EOC patients with MetS in Chinese population were found to have statistically significant tumor advanced stage, low differentiation, LN metastasis and poor prognosis.
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Affiliation(s)
- Ying Chen
- Department of Gynecologic Oncology, Tianjin Medical University Cancer Institute and Hospital, Huanhuxi Road, Hexi District, Tianjin, 300060 China.,Key Laboratory of Cancer Prevention and Therapy, Tianjin, 300060 China.,National Clinical Research Centre of Cancer, Tianjin, 300060 China
| | - Lei Zhang
- Department of Gynecologic Oncology, Tianjin Medical University Cancer Institute and Hospital, Huanhuxi Road, Hexi District, Tianjin, 300060 China.,Key Laboratory of Cancer Prevention and Therapy, Tianjin, 300060 China.,National Clinical Research Centre of Cancer, Tianjin, 300060 China
| | - Wenxin Liu
- Department of Gynecologic Oncology, Tianjin Medical University Cancer Institute and Hospital, Huanhuxi Road, Hexi District, Tianjin, 300060 China
| | - Ke Wang
- Department of Gynecologic Oncology, Tianjin Medical University Cancer Institute and Hospital, Huanhuxi Road, Hexi District, Tianjin, 300060 China
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Perceptions of weight management counseling among gynecologic cancer survivors: opportunities for enhancing survivorship care. Support Care Cancer 2017; 25:1537-1545. [DOI: 10.1007/s00520-016-3552-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2016] [Accepted: 12/20/2016] [Indexed: 01/13/2023]
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Abstract
Measures of body weight and anthropometrics such as body mass index (BMI) are commonly used to assess nutritional status in clinical conditions including cancer. Extensive research has evaluated associations between body weight and prognosis in ovarian cancer patients, yet little is known about the potential impact of body composition (fat mass (FM) and fat-free mass (FFM)) in these patients. Thus, the purpose of this publication was to review the literature (using PubMed and EMBASE) evaluating the impact of body weight and particularly body composition on surgical complications, morbidity, chemotherapy dosing and toxicity (as predictors of prognosis), and survival in ovarian cancer patients. Body weight is rarely associated with intra-operative complications, but obesity predicts higher rates of venous thromboembolism and wound complications post-operatively in ovarian cancer patients. Low levels of FM and FFM are superior predictors of length of hospital stay compared to measures of body weight alone, but the role of body composition on other surgical morbidities is unknown. Obesity complicates chemotherapy dosing due to altered pharmacokinetics, imprecise dosing strategies, and wide variability in FM and FFM. Measurement of body composition has the potential to reduce toxicity if the results are incorporated into chemotherapy dosing calculations. Some findings suggest that excess body weight adversely affects survival, while others find no such association. Limited studies indicate that FM is a better predictor of survival than body weight in ovarian cancer patients, but the direction of this relationship has not been determined. In conclusion, body composition as an indicator of nutritional status is a better prognostic tool than body weight or BMI alone in ovarian cancer patients.
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Smits A, Lopes A, Das N, Kumar A, Cliby W, Smits E, Bekkers R, Massuger L, Galaal K. Surgical morbidity and clinical outcomes in ovarian cancer - the role of obesity. BJOG 2016; 123:300-8. [PMID: 26331299 DOI: 10.1111/1471-0528.13585] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/28/2015] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To evaluate the effect of body mass index on the surgical outcomes in ovarian cancer patients. In addition, we performed a systematic review to compare our outcomes with the current literature. DESIGN Retrospective cohort study and a systematic review of the literature. SETTING Gynaecology department at the Royal Cornwall Hospital Trust. POPULATION Surgically managed stage I-IV ovarian cancer patients between September 2006 and September 2014. METHODS Primary and secondary outcome measures were evaluated across BMI categories; BMI <25 kg/m², BMI 25–29.9 kg/m², BMI ≥30 kg/m² and BMI ≥40 kg/m². A systematic review was performed according to Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. MAIN OUTCOME MEASURES The primary outcome measure was surgical complications. Secondary outcome measures were other intra- and postoperative outcomes. RESULTS Two hundred twenty-eight women were included in the study, of which 84 had a BMI <25 kg/m², 84 women had a BMI 25–29.9 kg/m², and 60 women were obese (BMI ≥30 kg/m²), 13 of whom were morbidly obese. Morbid obesity was associated with increased rates of wound complications. However, BMI did not show an association with other outcomes. In the review, an increasing BMI was associated with increased rates of wound complications and prolonged hospital stay, but did not impact other surgical outcomes. CONCLUSION Obesity is associated with increased rates of wound complications and a prolonged hospital stay, but does not appear to affect other operative outcomes including cytoreduction status and 30-day mortality. Therefore, operative management and postoperative care require a multifactorial approach to minimise adverse outcomes.
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Orekoya O, Samson ME, Trivedi T, Vyas S, Steck SE. The Impact of Obesity on Surgical Outcome in Endometrial Cancer Patients: A Systematic Review. J Gynecol Surg 2016; 32:149-157. [PMID: 27274182 DOI: 10.1089/gyn.2015.0114] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background: Obesity is a significant public health problem in the United States, and many studies have established obesity as a significant risk factor for endometrial cancer. Surgery is the standard of care in staging and treatment of endometrial cancer, and obesity may influence surgical outcomes because of its attendant comorbid conditions. Therefore, assessment of the impact of obesity on surgical outcome is important for decreasing morbidity and improving survival in patients with endometrial cancer. Objective: The aims of this research were to evaluate and review epidemiologic data systematically on the impact of obesity on surgical outcomes and to assess safety and feasibility of newer surgical techniques in obese patients. Materials and Methods: A systematic search of PubMed was conducted to identify articles between 2004 and 2013 that focused on the impact of obesity on surgical outcome. Reference lists of retrieved articles were also used to identify other relevant articles. Thirteen relevant articles were reviewed. Results: Evidence from epidemiologic studies showed that obesity impacts surgical outcome adversely. On average, obese patients have worse surgical outcomes than their nonobese counterparts. In addition, surgical outcome worsens as level of obesity increases. However, surgical procedure also influences this association. Minimally invasive surgeries are more useful and are accompanied with fewer complications than conventional laparotomy and can be performed safely in obese patients. Conclusions: Obesity is a significant risk in the etiology, treatment, and surgical outcomes of patients with endometrial cancer. Future research will need more randomized controlled trials and prospective studies to identify the best procedures for maximal outcomes. (J GYNECOL SURG 32:149).
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Affiliation(s)
- Olubunmi Orekoya
- Department of Epidemiology and Biostatistics, Cancer Prevention and Control Program, and Arnold School of Public Health, University of South Carolina , Columbia, SC
| | - Marsha E Samson
- Department of Epidemiology and Biostatistics, Cancer Prevention and Control Program, and Arnold School of Public Health, University of South Carolina , Columbia, SC
| | - Tushar Trivedi
- Department of Epidemiology and Biostatistics, Cancer Prevention and Control Program, and Arnold School of Public Health, University of South Carolina , Columbia, SC
| | - Shraddha Vyas
- Department of Epidemiology and Biostatistics, Cancer Prevention and Control Program, and Arnold School of Public Health, University of South Carolina , Columbia, SC
| | - Susan E Steck
- Department of Epidemiology and Biostatistics, Cancer Prevention and Control Program, and Arnold School of Public Health, University of South Carolina , Columbia, SC
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Investigating the Impact of Body Mass Index on Intraperitoneal Chemotherapy Outcomes in Ovarian and Fallopian Tube Cancer. Int J Gynecol Cancer 2016; 26:1033-40. [PMID: 27206282 DOI: 10.1097/igc.0000000000000729] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVES The aim of this study was to investigate the impact of body mass index (BMI) on completion, complications, and clinical outcomes of intraperitoneal (IP) chemotherapy in patients with advanced-stage ovarian cancer. METHODS Patients with optimally cytoreduced International Federation of Gynecology and Obstetrics stage IIIC ovarian cancer treated with IP chemotherapy were retrospectively identified using an institutional review board-approved database. Clinical data were abstracted from the longitudinal medical record. Survival estimates were calculated using the Kaplan-Meier method. RESULTS Ninety-two patients (35.5%) completed at least one cycle of IP chemotherapy. For these patients, there was no difference in histology, surgical complexity, or degree of cytoreduction based on BMI. Sixty-five percent of normal weight, 70% of overweight, and 59.1% of obese women completed 6 cycles (P = 0.697). There was also no significant difference in IP chemotherapy complications (P = 0.303). Body mass index had no impact on disease-free survival (P = 0.44) or overall survival, with a median overall survival of 68.5 months for normal weight, 65.9 months for overweight, and 61.7 months for obese women (P = 0.25). However, on multivariate analysis, obesity had an odds ratio of 2.92 (P = 0.02) for mortality. There was a trend toward treatment with intravenous chemotherapy (84.2%) over IP (15.8%) in patients with class II obesity (P = 0.06). DISCUSSION There was no difference in completion of IP chemotherapy or complications with respect to BMI; however, there was a trend away from treatment with IP therapy in extreme obesity. These data suggest that IP chemotherapy is feasible in obese patients without incurring increased morbidity.
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Morris M, Friedemann Smith C, Boxell E, Wardle J, Simon A, Waller J. Quantitative evaluation of an information leaflet to increase prompt help-seeking for gynaecological cancer symptoms. BMC Public Health 2016; 16:374. [PMID: 27142652 PMCID: PMC4855769 DOI: 10.1186/s12889-016-3032-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2016] [Accepted: 04/22/2016] [Indexed: 11/10/2022] Open
Abstract
Background Provision of written information may improve awareness of cancer symptoms and encourage timely presentation in primary care. This study assessed changes in symptom knowledge, perceived barriers to help-seeking, anxiety and intention to seek help, following exposure to a leaflet to raise awareness of gynaecological cancer symptoms. Methods Women (N = 484) completed questionnaires before and after reading the leaflet. The primary outcome was change in anticipated time to help-seeking for 12 symptoms. Changes in symptom knowledge, barriers and anxiety, and their association with prompt help-seeking were evaluated using Wilcoxon signed rank tests and logistic regression analyses. Results After reading the leaflet, symptom knowledge increased (p < 0.001), and perceived barriers (p < 0.001) and anxiety (p = 0.008) decreased. The number of symptoms for which women anticipated seeking help promptly increased (p < 0.001). Changes in knowledge (OR 4.21, 95 % CI 1.95-9.13) and perceived barriers (OR 4.60, 95 % CI 1.91-11.04) were independently associated with increased help-seeking. Conclusion Increased symptom knowledge and lowered perceived barriers were related to increased prompt anticipated help-seeking. This occurred without an increase in anxiety. This intervention is effective in altering knowledge, beliefs and help-seeking intentions for gynaecological cancer symptoms, at least in the short-term, and should be trialled in primary care. Electronic supplementary material The online version of this article (doi:10.1186/s12889-016-3032-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Melanie Morris
- Health Behaviour Research Centre, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK.,Present address: Cancer Research UK Cancer Survival Group, London School of Hygiene and Tropical Medicine, London, UK
| | - Claire Friedemann Smith
- Health Behaviour Research Centre, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK
| | - Emily Boxell
- Health Behaviour Research Centre, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK
| | - Jane Wardle
- Health Behaviour Research Centre, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK
| | - Alice Simon
- Health Behaviour Research Centre, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK.,Present address: Health Services Research, School of Health Sciences, City University London, London, UK
| | - Jo Waller
- Health Behaviour Research Centre, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK.
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Bandera EV, Lee VS, Rodriguez-Rodriguez L, Powell CB, Kushi LH. Impact of Chemotherapy Dosing on Ovarian Cancer Survival According to Body Mass Index. JAMA Oncol 2016; 1:737-45. [PMID: 26181758 DOI: 10.1001/jamaoncol.2015.1796] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
IMPORTANCE Optimal chemotherapy dosing in obese patients remains uncertain, with variation in practice. Dose reduction strategies are often used to avoid chemotoxicity, but recent American Society of Clinical Oncology guidelines recommend full dose. OBJECTIVE To evaluate the impact of body mass index (BMI) on chemotherapy dosing and of dose reduction on ovarian cancer survival. DESIGN, SETTING, AND PARTICIPANTS Cohort study in Kaiser Permanente Northern California (KPNC) health care setting of patients with primary invasive epithelial ovarian cancers diagnosed from January 2000 through March 2013. Analyses focused on 806 patients receiving adjuvant first-line therapy of carboplatin and paclitaxel with curative intent. MAIN OUTCOMES AND MEASURES Overall and ovarian cancer-specific mortality. Deaths were identified through the KPNC Mortality Linkage System, with median follow-up of 52.5 months. Hazard ratios (HRs) and 95% CIs were estimated from proportional hazards regression, accounting for prognostic variables including age at diagnosis, race, stage, grade, histologic type, chemotoxic effects, comorbidities, cancer antigen 125 levels, and BMI at diagnosis. RESULTS The strongest predictor of dose reduction was a high BMI. Compared with normal-weight women, obese class III women received 38% and 45% lower doses in milligrams per kilogram of body weight of paclitaxel and carboplatin, respectively (P < .001 for each agent). They also received lower relative dose intensity (RDI) for each agent and the combined regimen, calculated as average RDI (ARDI). Mean ARDI was 73.7% for obese class III women and 88.2% for normal-weight women (P < .001). Lower ARDI (<70%) was associated with worse overall (HR, 1.62 [95% CI, 1.10-2.37]) and ovarian cancer-specific survival (HR, 1.69 [95% CI, 1.12-2.55]). Women who were obese at diagnosis appeared to have better survival. In multivariable-adjusted analyses considering joint effects by BMI and ARDI, compared with women with normal weight and no dose reduction, normal-weight women with dose reduction (ARDI < 85%) experienced worse survival (HR, 1.50 [95% CI, 1.02-2.21]). For each BMI category, those with ARDI less than 85% had worse survival than those without dose reduction. The improved survival among obese women was no longer apparent with dose reduction. CONCLUSIONS AND RELEVANCE Lower RDI was an independent predictor of ovarian cancer mortality. This finding was strongest among normal-weight women but seen at all levels of BMI. Our results suggest that body size should not be a major factor influencing dose reduction decisions in women with ovarian cancer.
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Affiliation(s)
- Elisa V Bandera
- Cancer Prevention and Control, Rutgers Cancer Institute of New Jersey, New Brunswick2Department of Medicine, Rutgers Robert Wood Johnson Medical School, New Brunswick
| | - Valerie S Lee
- Division of Research, Kaiser Permanente Northern California, Oakland
| | - Lorna Rodriguez-Rodriguez
- Precision Medicine, Division of Gynecologic Oncology, Rutgers Cancer Institute of New Jersey, New Brunswick
| | - C Bethan Powell
- Gynecologic Oncology, Kaiser Permanente Northern California, San Francisco
| | - Lawrence H Kushi
- Division of Research, Kaiser Permanente Northern California, Oakland6Division of Hematology and Oncology, Department of Internal Medicine, University of California Davis School of Medicine, Sacramento
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Impact of obesity on treatment-related adverse events, disease recurrence, and survival in women with cervical carcinoma. ACTA ACUST UNITED AC 2016. [DOI: 10.1007/s13566-016-0243-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Bešević J, Gunter MJ, Fortner RT, Tsilidis KK, Weiderpass E, Charlotte Onland-Moret N, Dossus L, Tjønneland A, Hansen L, Overvad K, Mesrine S, Baglietto L, Clavel-Chapelon F, Kaaks R, Aleksandrova K, Boeing H, Trichopoulou A, Lagiou P, Bamia C, Masala G, Agnoli C, Tumino R, Ricceri F, Panico S, Bueno-de-Mesquita HB, Peeters PH, Jareid M, Ramón Quirós J, Duell EJ, Sánchez MJ, Larrañaga N, Chirlaque MD, Barricarte A, Dias JA, Sonestedt E, Idahl A, Lundin E, Wareham NJ, Khaw KT, Travis RC, Rinaldi S, Romieu I, Riboli E, Merritt MA. Reproductive factors and epithelial ovarian cancer survival in the EPIC cohort study. Br J Cancer 2015; 113:1622-31. [PMID: 26554655 PMCID: PMC4705888 DOI: 10.1038/bjc.2015.377] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2015] [Revised: 10/06/2015] [Accepted: 10/08/2015] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Reproductive factors influence the risk of developing epithelial ovarian cancer (EOC), but little is known about their association with survival. We tested whether prediagnostic reproductive factors influenced EOC-specific survival among 1025 invasive EOC cases identified in the European Prospective Investigation into Cancer and Nutrition (EPIC) study, which included 521,330 total participants (approximately 370,000 women) aged 25-70 years at recruitment from 1992 to 2000. METHODS Information on reproductive characteristics was collected at recruitment. Cox proportional hazards regression models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs), and multivariable models were adjusted for age and year of diagnosis, body mass index, tumour stage, smoking status and stratified by study centre. RESULTS After a mean follow-up of 3.6 years (±3.2 s.d.) following EOC diagnosis, 511 (49.9%) of the 1025 women died from EOC. We observed a suggestive survival advantage in menopausal hormone therapy (MHT) users (ever vs never use, HR=0.80, 95% CI=0.62-1.03) and a significant survival benefit in long-term MHT users (⩾5 years use vs never use, HR=0.70, 95% CI=0.50-0.99, P(trend)=0.04). We observed similar results for MHT use when restricting to serous cases. Other reproductive factors, including parity, breastfeeding, oral contraceptive use and age at menarche or menopause, were not associated with EOC-specific mortality risk. CONCLUSIONS Further studies are warranted to investigate the possible improvement in EOC survival in MHT users.
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Affiliation(s)
- Jelena Bešević
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, Norfolk Place, London W2 1PG, UK
| | - Marc J Gunter
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, Norfolk Place, London W2 1PG, UK
| | - Renée T Fortner
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, Heidelberg 69120, Germany
| | - Konstantinos K Tsilidis
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, Norfolk Place, London W2 1PG, UK
- Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, University Campus, Ioannina 45110, Greece
| | - Elisabete Weiderpass
- Department of Community Medicine, Faculty of Health Sciences, University of Tromsø–The Arctic University of Norway, Tromsø N–9037, Norway
- Department of Research, Cancer Registry of Norway, PB 5313 Majorstuen, 0304 Oslo, Norway
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, PO Box 281, Stockholm 17177, Sweden
- Genetic Epidemiology Group, Folkhälsan Research Center, FI-00290 Helsinki, Finland
| | - N Charlotte Onland-Moret
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Huispost Str. 6.131, PO Box 85500, Utrecht 3508 GA, The Netherlands
| | - Laure Dossus
- Inserm, Center for Research in Epidemiology and Population Health (CESP), U1018, Lifestyle, Genes and Health: Integrative Trans-generational Epidemiology, Villejuif F-94805, France
- Université Paris Sud, UMRS 1018, Villejuif F-94805, France
- Institut Gustave Roussy, Villejuif F-94805, France
| | - Anne Tjønneland
- Danish Cancer Society Research Center, Strandboulevarden 49, Copenhagen DK-2100, Denmark
| | - Louise Hansen
- Danish Cancer Society Research Center, Strandboulevarden 49, Copenhagen DK-2100, Denmark
| | - Kim Overvad
- Section for Epidemiology, Department of Public Health, Aarhus University, Bartholins Alle 2, Aarhus C DK-8000, Denmark
| | - Sylvie Mesrine
- Inserm, Center for Research in Epidemiology and Population Health (CESP), U1018, Lifestyle, Genes and Health: Integrative Trans-generational Epidemiology, Villejuif F-94805, France
- Université Paris Sud, UMRS 1018, Villejuif F-94805, France
- Institut Gustave Roussy, Villejuif F-94805, France
| | - Laura Baglietto
- Cancer Epidemiology Center, Cancer Council of Victoria, 615 St Kilda Road, Melbourne 3004, Victoria, Australia
- Center for Epidemiology and Biostatistics, School of Population and Global Health, University of Melbourne, Melbourne 3010, Victoria, Australia
| | - Françoise Clavel-Chapelon
- Inserm, Center for Research in Epidemiology and Population Health (CESP), U1018, Lifestyle, Genes and Health: Integrative Trans-generational Epidemiology, Villejuif F-94805, France
- Université Paris Sud, UMRS 1018, Villejuif F-94805, France
- Institut Gustave Roussy, Villejuif F-94805, France
| | - Rudolf Kaaks
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, Heidelberg 69120, Germany
| | - Krasimira Aleksandrova
- Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke, Arthur-Scheunert-Allee 114–116, Nuthetal 14558, Germany
| | - Heiner Boeing
- Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke, Arthur-Scheunert-Allee 114–116, Nuthetal 14558, Germany
| | - Antonia Trichopoulou
- Hellenic Health Foundation, 13 Kaisareias Street, Athens GR-115 27, Greece
- Bureau of Epidemiologic Research, Academy of Athens, 23 Alexandroupoleos Street, Athens GR-115 27, Greece
| | - Pagona Lagiou
- Department of Epidemiology, Harvard School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USA
- Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School, Mikras Asias 75, Goudi, Athens GR-115 27, Greece
| | - Christina Bamia
- Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School, Mikras Asias 75, Goudi, Athens GR-115 27, Greece
| | - Giovanna Masala
- Molecular and Nutritional Epidemiology Unit, Cancer Research and Prevention Institute–ISPO, Ponte Nuovo Palazzina 28A ‘Mario Fiori', Via delle Oblate 4, Florence 50141, Italy
| | - Claudia Agnoli
- Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Venezian, 1, Milano 20133, Italy
| | - Rosario Tumino
- Cancer Registry and Histopathology Unit, ‘Civic–M.P. Arezzo' Hospital, ASP, Via Dante No. 109, Ragusa 97100, Italy
| | - Fulvio Ricceri
- Unit of Epidemiology, Regional Health Service ASL TO3, Via Sabaudia 164, Grugliasco (TO) 10095, Italy
- Unit of Cancer Epidemiology, Department of Medical Sciences, University of Turin, Via Santena 7, Turin 10126, Italy
| | - Salvatore Panico
- Dipartimento di Medicina Clinica e Chirurgia, Federico II University, via Pansini 5, 80131 Naples, Italy
| | - HB(as) Bueno-de-Mesquita
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, Norfolk Place, London W2 1PG, UK
- Department for Determinants of Chronic Diseases (DCD), National Institute for Public Health and the Environment (RIVM), PO Box 1, Bilthoven 3720 BA, The Netherlands
- Department of Gastroenterology and Hepatology, University Medical Center Utrecht, Heidelberglann 100, Utrecht 3584 cx, The Netherlands
- Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia
| | - Petra H Peeters
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, Norfolk Place, London W2 1PG, UK
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Huispost Str. 6.131, PO Box 85500, Utrecht 3508 GA, The Netherlands
| | - Mie Jareid
- Department of Community Medicine, Faculty of Health Sciences, University of Tromsø–The Arctic University of Norway, Tromsø N–9037, Norway
| | - J Ramón Quirós
- Public Health Directorate, Asturias, Ciriaco Miguel Vigil St 9, Oviedo 33006, Spain
| | - Eric J Duell
- Unit of Nutrition and Cancer, Cancer Epidemiology Research Program, Catalan Institute of Oncology (ICO-IDIBELL), Avda Gran Via 199-203, 08908 L'Hospitalet de Llobregat, Barcelona, Spain
| | - María-José Sánchez
- Escuela Andaluza de Salud Pública, Instituto de Investigación Biosanitaria ibs, Hospitales Universitarios de Granada/Universidad de Granada, Cuesta del Observatorio, 4, Campus Universitario de Cartuja, Granada 18080, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP), Melchor Fernández Almagro, 3-5, Madrid 28029, Spain
| | - Nerea Larrañaga
- CIBER de Epidemiología y Salud Pública (CIBERESP), Melchor Fernández Almagro, 3-5, Madrid 28029, Spain
- Public Health Division of Gipuzkoa, Regional Government of the Basque Country, Donostia, Spain
| | - María-Dolores Chirlaque
- CIBER de Epidemiología y Salud Pública (CIBERESP), Melchor Fernández Almagro, 3-5, Madrid 28029, Spain
- Department of Epidemiology, Murcia Regional Health Council, IMIB–Arrixaca, Ronda de Levante 11, Murcia 30008, Spain
| | - Aurelio Barricarte
- CIBER de Epidemiología y Salud Pública (CIBERESP), Melchor Fernández Almagro, 3-5, Madrid 28029, Spain
- Navarra Public Health Institute, c/Leyre 15, Pamplona 31003, Spain
- IdiSNA, Navarra Institute for Health Research, Recinto de Complejo Hospitalario de Navarra c/Irunlarrea 3, Pamplona 31008, Spain
| | - Joana A Dias
- Department of Clinical Sciences Malmö, Lund University, Malmö 20502, Sweden
| | - Emily Sonestedt
- Department of Clinical Sciences Malmö, Lund University, Malmö 20502, Sweden
| | - Annika Idahl
- Department of Clinical Sciences, Obstetrics and Gynecology, Umeå University, SE-901 87 Umeå, Sweden
- Department of Public Health and Clinical Medicine, Nutritional Research, Umeå University, SE-901 87 Umeå, Sweden
| | - Eva Lundin
- Department of Medical Biosciences and Pathology, Umeå University, Umeå SE-901 87, Sweden
| | - Nicholas J Wareham
- MRC Epidemiology Unit, University of Cambridge, Institute of Metabolic Science, Box 285, Addenbrooke's Hospital, Hills Road, Cambridge CB2 0QQ, UK
| | - Kay-Tee Khaw
- School of Clinical Medicine, University of Cambridge, Addenbrooke's Hospital, Hills Rd, Cambridge CB2 0SP, UK
| | - Ruth C Travis
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Richard Doll Building, Oxford OX3 7LF, UK
| | - Sabina Rinaldi
- International Agency for Research on Cancer, 150 Cours Albert-Thomas, Lyon Cedex 08 69372, France
| | - Isabelle Romieu
- International Agency for Research on Cancer, 150 Cours Albert-Thomas, Lyon Cedex 08 69372, France
| | - Elio Riboli
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, Norfolk Place, London W2 1PG, UK
| | - Melissa A Merritt
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, Norfolk Place, London W2 1PG, UK
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Bohlin KS, Ankardal M, Stjerndahl JH, Lindkvist H, Milsom I. Influence of the modifiable life-style factors body mass index and smoking on the outcome of hysterectomy. Acta Obstet Gynecol Scand 2015; 95:65-73. [PMID: 26459279 DOI: 10.1111/aogs.12794] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2015] [Accepted: 09/28/2015] [Indexed: 12/11/2022]
Abstract
INTRODUCTION The aim of this study was to study the impact of body mass index (BMI) and smoking on the outcome of hysterectomy and whether effects of these factors vary between abdominal, laparoscopic and vaginal hysterectomy. MATERIAL AND METHODS Pre-, per- and postoperative (8 weeks) data were retrieved from the Swedish National Register for Gynecological Surgery on 28 537 hysterectomies performed because of a benign indication between 2004 and 2013. Multivariable logistic regression analyses were used to identify independent factors affecting the rate of complications, presented as adjusted odds ratios (adjOR) with 95% confidence intervals (CI). RESULTS Overweight and obesity had the strongest impact on complications in the abdominal hysterectomy group. In women with a BMI ≥ 30 an increased adjOR could be seen for bleeding >1000 mL (2.90; 95% CI 2.23-3.77), peroperative complications (1.54; 95% CI 1.26-1.88), operation time >120 min (2.67; 95% CI 2.33-3.03), postoperative complications (1.21; 95% CI 1.08-1.34) and postoperative infections (1.73; 95% CI 1.50-1.99). With vaginal hysterectomy, the effect of BMI ≥ 30 could be seen in relation to excessive bleeding >500 mL (1.63; 95% CI 1.22-2.17) and operative time >120 min (2.00; 95% CI 1.60-2.50). With laparoscopic hysterectomy (LH), a BMI ≥ 30 had a higher adjOR for prolonged surgery (1.71; 95% CI 1.30-2.26). Smokers had an increased risk of postoperative infection in the abdominal hysterectomy (1.23; 95% CI 1.07-1.40) and vaginal hysterectomy groups (1.21; 95% CI 1.02-1.43) but not in the LH group. CONCLUSIONS Body mass index and smoking had a negative effect with all hysterectomy approaches but to a lesser extent in vaginal and laparoscopic hysterectomies. This should be taken into consideration in advance of surgery to improve outcome.
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Affiliation(s)
- Katja S Bohlin
- Department of Obstetrics and Gynecology, Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden
| | - Maud Ankardal
- Department of Gynecology, Halmstad Hospital, Halmstad, Sweden
| | - Jan-Henrik Stjerndahl
- Department of Obstetrics and Gynecology, Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden
| | - Håkan Lindkvist
- Department of Mathematics and Mathematical Statistics, Umeå University, Umeå, Sweden
| | - Ian Milsom
- Department of Obstetrics and Gynecology, Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden
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Blikkendaal MD, Schepers EM, van Zwet EW, Twijnstra ARH, Jansen FW. Hysterectomy in very obese and morbidly obese patients: a systematic review with cumulative analysis of comparative studies. Arch Gynecol Obstet 2015; 292:723-38. [PMID: 25773357 PMCID: PMC4560773 DOI: 10.1007/s00404-015-3680-7] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2014] [Accepted: 02/25/2015] [Indexed: 12/12/2022]
Abstract
PURPOSE Some studies suggest that also regarding the patient with a body mass index (BMI) ≥35 kg/m(2) the minimally invasive approach to hysterectomy is superior. However, current practice and research on the preference of gynaecologists still show that the rate of abdominal hysterectomy (AH) increases as the BMI increases. A systematic review with cumulative analysis of comparative studies was performed to evaluate the outcomes of AH, laparoscopic hysterectomy (LH) and vaginal hysterectomy (VH) in very obese and morbidly obese patients (BMI ≥35 kg/m(2)). METHODS PubMed and EMBASE were searched for records on AH, LH and VH for benign indications or (early stage) malignancy through October 2014. Included studies were graded on level of evidence. Studies with a comparative design were pooled in a cumulative analysis. RESULTS Two randomized controlled trials, seven prospective studies and 14 retrospective studies were included (2232 patients; 1058 AHs, 959 LHs, and 215 VHs). The cumulative analysis identified that, compared to LH, AH was associated with more wound dehiscence [risk ratio (RR) 2.58, 95 % confidence interval (CI) 1.71-3.90; P = 0.000], more wound infection (RR 4.36, 95 % CI 2.79-6.80; P = 0.000), and longer hospital admission (mean difference 2.9 days, 95 % CI 1.96-3.74; P = 0.000). The pooled conversion rate was 10.6 %. Compared to AH, VH was associated with similar advantages as LH. CONCLUSIONS Compared to AH, both LH and VH are associated with fewer postoperative complications and shorter length of hospital stay. Therefore, the feasibility of LH and VH should be considered prior the abdominal approach to hysterectomy in very obese and morbidly obese patients.
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Affiliation(s)
- Mathijs D. Blikkendaal
- Department of Gynaecology, Leiden University Medical Centre, PO Box 9600, 2300 RC Leiden, The Netherlands
| | - Evelyn M. Schepers
- Department of Gynaecology, Bronovo Hospital, PO Box 96900, 2509 JH The Hague, The Netherlands
| | - Erik W. van Zwet
- Department of Medical Statistics, Leiden University Medical Centre, PO Box 9600, 2300 RC Leiden, The Netherlands
| | - Andries R. H. Twijnstra
- Department of Gynaecology, Leiden University Medical Centre, PO Box 9600, 2300 RC Leiden, The Netherlands
| | - Frank Willem Jansen
- Department of Gynaecology, Leiden University Medical Centre, PO Box 9600, 2300 RC Leiden, The Netherlands
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Wang JW, Sun L, Li J, Cong XH, Chen XF, Tang Z, Yu DH, Zhang TR, Luo ZN, Yuan ZP, Yu JM. Comorbid chronic diseases and their associations with quality of life among gynecological cancer survivors. BMC Public Health 2015; 15:965. [PMID: 26408314 PMCID: PMC4582736 DOI: 10.1186/s12889-015-2240-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2014] [Accepted: 09/07/2015] [Indexed: 11/12/2022] Open
Abstract
Background Many gynecological cancer survivors (GCS) have comorbid chronic diseases (CCD). This study was to estimate the impacts of CCD on quality of life (QOL) in GCS. Methods We collected cross-sectional self-reported survey data from 598 GCS between April and July 2013, in Shanghai, China. All the subjects were asked to complete a questionnaire containing the European Organization for Research and Treatment quality of life version 3 questionnaire (EORTC QLQ-C30) and questions on socio-demographic characteristics and CCD. In order to mitigate the bias caused by confounding factors, multiple linear models were employed to calculate adjusted means of QOL scores. Results Approximately three-quarters of subjects reported at least one CCD. The highest overall prevalence of all CCD was found in endometrial cancer survivors. Subjects with CCD generally reported lower scores for most EORTC QLQ-C30 scales when compared to subjects without CCD, indicating poorer QOL, particularly for cardiovascular diseases, respiratory diseases, digestive diseases, and musculoskeletal disease. Conclusions The CCD are common health problems among GCS. CCD have significantly negative influence on QOL, and GCS with CCD generally reported lower QOL scores. These findings suggested comprehensive cares for GCS.
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Affiliation(s)
- Ji-Wei Wang
- School of public health and Key Laboratory of Public Health Safety, Fudan University, 30 Dong-An Road, Shanghai, 200032, China
| | - Li Sun
- School of public health and Key Laboratory of Public Health Safety, Fudan University, 30 Dong-An Road, Shanghai, 200032, China
| | - Jiang Li
- Jonathan and Karin Fielding School of Public Health, University of California, 650 Charles Young Drive South, Los Angeles, CA, 90095, USA
| | - Xiao-Huan Cong
- School of public health and Key Laboratory of Public Health Safety, Fudan University, 30 Dong-An Road, Shanghai, 200032, China
| | - Xue-Fen Chen
- School of public health and Key Laboratory of Public Health Safety, Fudan University, 30 Dong-An Road, Shanghai, 200032, China
| | - Zheng Tang
- School of public health and Key Laboratory of Public Health Safety, Fudan University, 30 Dong-An Road, Shanghai, 200032, China
| | - Dong-Hui Yu
- College of Clinical Medicine, Anhui Medical University, Hefei, Anhui Province, China
| | - Tian-Rui Zhang
- School of public health and Key Laboratory of Public Health Safety, Fudan University, 30 Dong-An Road, Shanghai, 200032, China
| | - Zheng-Nian Luo
- Shanghai Health Education Association, 122 Shan-Xi-Nan Road, 200040, Shanghai, China
| | - Zheng-Ping Yuan
- Shanghai Cancer Rehabilitation Club, 2795 Yang-Gao-Zhong Road, Shanghai, 200135, China
| | - Jin-Ming Yu
- School of public health and Key Laboratory of Public Health Safety, Fudan University, 30 Dong-An Road, Shanghai, 200032, China.
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Nagle CM, Dixon SC, Jensen A, Kjaer SK, Modugno F, deFazio A, Fereday S, Hung J, Johnatty SE, Fasching PA, Beckmann MW, Lambrechts D, Vergote I, Van Nieuwenhuysen E, Lambrechts S, Risch HA, Rossing MA, Doherty JA, Wicklund KG, Chang-Claude J, Goodman MT, Ness RB, Moysich K, Heitz F, du Bois A, Harter P, Schwaab I, Matsuo K, Hosono S, Goode EL, Vierkant RA, Larson MC, Fridley BL, Høgdall C, Schildkraut JM, Weber RP, Cramer DW, Terry KL, Bandera EV, Paddock L, Rodriguez-Rodriguez L, Wentzensen N, Yang HP, Brinton LA, Lissowska J, Høgdall E, Lundvall L, Whittemore A, McGuire V, Sieh W, Rothstein J, Sutphen R, Anton-Culver H, Ziogas A, Pearce CL, Wu AH, Webb PM. Obesity and survival among women with ovarian cancer: results from the Ovarian Cancer Association Consortium. Br J Cancer 2015; 113:817-26. [PMID: 26151456 PMCID: PMC4559823 DOI: 10.1038/bjc.2015.245] [Citation(s) in RCA: 101] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2015] [Revised: 06/01/2015] [Accepted: 06/10/2015] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Observational studies have reported a modest association between obesity and risk of ovarian cancer; however, whether it is also associated with survival and whether this association varies for the different histologic subtypes are not clear. We undertook an international collaborative analysis to assess the association between body mass index (BMI), assessed shortly before diagnosis, progression-free survival (PFS), ovarian cancer-specific survival and overall survival (OS) among women with invasive ovarian cancer. METHODS We used original data from 21 studies, which included 12 390 women with ovarian carcinoma. We combined study-specific adjusted hazard ratios (HRs) using random-effects models to estimate pooled HRs (pHR). We further explored associations by histologic subtype. RESULTS Overall, 6715 (54%) deaths occurred during follow-up. A significant OS disadvantage was observed for women who were obese (BMI: 30-34.9, pHR: 1.10 (95% confidence intervals (CIs): 0.99-1.23); BMI: ⩾35, pHR: 1.12 (95% CI: 1.01-1.25)). Results were similar for PFS and ovarian cancer-specific survival. In analyses stratified by histologic subtype, associations were strongest for women with low-grade serous (pHR: 1.12 per 5 kg m(-2)) and endometrioid subtypes (pHR: 1.08 per 5 kg m(-2)), and more modest for the high-grade serous (pHR: 1.04 per 5 kg m(-2)) subtype, but only the association with high-grade serous cancers was significant. CONCLUSIONS Higher BMI is associated with adverse survival among the majority of women with ovarian cancer.
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Affiliation(s)
- C M Nagle
- Population Health Department, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - S C Dixon
- Population Health Department, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
- School of Population Health, University of Queensland, Brisbane, QLD, Australia
| | - A Jensen
- Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - S K Kjaer
- Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark
- Department of Gynecology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - F Modugno
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, Pennsylvania, PA, USA
- Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pennsylvania, PA, USA
- Womens Cancer Research Program, Magee-Womens Research Institute and University of Pittsburgh Cancer Institute, Pennsylvania, PA, USA
| | - A deFazio
- Department of Gynaecological Oncology, Westmead Hospital, Westmead, NSW, Australia
- Center for Cancer Research, University of Sydney at the Westmead Millennium Institute, Westmead, NSW, Australia
| | - S Fereday
- Peter MacCallum Cancer Centre, East Melbourne, VIC, Australia
| | - J Hung
- Department of Gynaecological Oncology, Westmead Hospital, Westmead, NSW, Australia
- Center for Cancer Research, University of Sydney at the Westmead Millennium Institute, Westmead, NSW, Australia
| | - S E Johnatty
- Genetics and Computational Biology Department, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - Australian Ovarian Cancer Study Group
- Population Health Department, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
- Peter MacCallum Cancer Centre, East Melbourne, VIC, Australia
| | - P A Fasching
- David Geffen School of Medicine, Department of Medicine Division of Hematology and Oncology, University of California at Los Angeles, Los Angeles, CA, USA
- Department of Gynecology and Obstetrics, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Comprehensive Cancer Center Erlangen-EMN, Erlangen, Germany
| | - M W Beckmann
- Department of Gynecology and Obstetrics, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Comprehensive Cancer Center Erlangen-EMN, Erlangen, Germany
| | - D Lambrechts
- Vesalius Research Center, VIB, Leuven, Belgium
- Department of Oncology, University of Leuven, Leuven, Belgium
| | - I Vergote
- Department of Obstetrics and Gynecology, Leuven Cancer Institute, University Hospitals Leuven, Leuven, Belgium
| | - E Van Nieuwenhuysen
- Department of Obstetrics and Gynecology, Leuven Cancer Institute, University Hospitals Leuven, Leuven, Belgium
| | - S Lambrechts
- Department of Obstetrics and Gynecology, Leuven Cancer Institute, University Hospitals Leuven, Leuven, Belgium
| | - H A Risch
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT, USA
| | - M A Rossing
- Program in Epidemiology, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - J A Doherty
- Department of Community and Family Medicine, The Geisel School of Medicine at Dartmouth, Lebanon, NH, USA
| | - K G Wicklund
- Program in Epidemiology, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - J Chang-Claude
- Division of Cancer Epidemiology, German Cancer Research Center, Heidelberg, Germany
| | - M T Goodman
- Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - R B Ness
- School of Public Health, University of Texas, Houston, TX, USA
| | - K Moysich
- Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo, NY, USA
| | - F Heitz
- Department of Gynecology and Gynecologic Oncology, Kliniken Essen-Mitte/Evang. Huyssens-Stiftung/Knappschaft GmbH, Essen, Germany
- Department of Gynecology and Gynecologic Oncology, Dr Horst Schmidt Kliniken Wiesbaden, Wiesbaden, Germany
| | - A du Bois
- Department of Gynecology and Gynecologic Oncology, Kliniken Essen-Mitte/Evang. Huyssens-Stiftung/Knappschaft GmbH, Essen, Germany
- Department of Gynecology and Gynecologic Oncology, Dr Horst Schmidt Kliniken Wiesbaden, Wiesbaden, Germany
| | - P Harter
- Department of Gynecology and Gynecologic Oncology, Kliniken Essen-Mitte/Evang. Huyssens-Stiftung/Knappschaft GmbH, Essen, Germany
- Department of Gynecology and Gynecologic Oncology, Dr Horst Schmidt Kliniken Wiesbaden, Wiesbaden, Germany
| | - I Schwaab
- Institut für Humangenetik Wiesbaden, Wiesbaden, Germany
| | - K Matsuo
- Department of Preventive Medicine, Faculty of Medical Sciences, Kyushu University, Nagoya, Aichi, Japan
| | - S Hosono
- Division of Epidemiology and Prevention, Aichi Cancer Center Research Institute, Nagoya, Aichi, Japan
| | - E L Goode
- Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - R A Vierkant
- Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - M C Larson
- Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - B L Fridley
- Department of Biostatistics, University of Kansas, Kansas City, KS, USA
| | - C Høgdall
- Department of Gynecology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - J M Schildkraut
- Department of Community and Family Medicine, Duke University Medical Center, Durham, NC, USA
| | - R P Weber
- Department of Community and Family Medicine, Duke University Medical Center, Durham, NC, USA
| | - D W Cramer
- Obstetrics and Gynecology Epidemiology Center, Brigham and Women's Hospital, Boston, MA, USA
| | - K L Terry
- Obstetrics and Gynecology Epidemiology Center, Brigham and Women's Hospital, Boston, MA, USA
| | - E V Bandera
- Rutgers Cancer Institute of New Jersey, Robert Wood Johnson Medical School, New Brunswick, NJ, USA
| | - L Paddock
- New Jersey State Cancer Registry, Trenton, NJ, USA
| | - L Rodriguez-Rodriguez
- Rutgers Cancer Institute of New Jersey, Robert Wood Johnson Medical School, New Brunswick, NJ, USA
| | - N Wentzensen
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - H P Yang
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - L A Brinton
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - J Lissowska
- Department of Cancer Epidemiology and Prevention, M. Sklodowska-Curie Cancer Center, Warsaw, Poland
| | - E Høgdall
- Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark
- Molecular Unit, Department of Pathology, Herlev Hospital, University of Copenhagen, Copenhagen, Denmark
| | - L Lundvall
- Department of Gynecology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - A Whittemore
- Department of Health Research and Policy–Epidemiology, Stanford University School of Medicine, Stanford, CA, USA
| | - V McGuire
- Department of Health Research and Policy–Epidemiology, Stanford University School of Medicine, Stanford, CA, USA
| | - W Sieh
- Department of Health Research and Policy–Epidemiology, Stanford University School of Medicine, Stanford, CA, USA
| | - J Rothstein
- Department of Health Research and Policy–Epidemiology, Stanford University School of Medicine, Stanford, CA, USA
| | - R Sutphen
- Epidemiology Center, College of Medicine, University of South Florida, Tampa, FL, USA
| | - H Anton-Culver
- Department of Epidemiology, School of Medicine, University of California Irvine, Irvine, California, USA
| | - A Ziogas
- Department of Epidemiology, School of Medicine, University of California Irvine, Irvine, California, USA
| | - C L Pearce
- Keck School of Medicine, University of Southern California Norris Comprehensive Cancer Center, Los Angeles, CA, USA
| | - A H Wu
- Keck School of Medicine, University of Southern California Norris Comprehensive Cancer Center, Los Angeles, CA, USA
| | - P M Webb
- Population Health Department, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
- School of Population Health, University of Queensland, Brisbane, QLD, Australia
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Modesitt SC, Hallowell PT, Slack-Davis JK, Michalek RD, Atkins KA, Kelley SL, Arapovic S, Shupnik MA, Hoehn K. Women at extreme risk for obesity-related carcinogenesis: Baseline endometrial pathology and impact of bariatric surgery on weight, metabolic profiles and quality of life. Gynecol Oncol 2015; 138:238-45. [DOI: 10.1016/j.ygyno.2015.05.015] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2015] [Accepted: 05/19/2015] [Indexed: 02/06/2023]
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The association between type 2 diabetes mellitus and women cancer: the epidemiological evidences and putative mechanisms. BIOMED RESEARCH INTERNATIONAL 2015; 2015:920618. [PMID: 25866823 PMCID: PMC4383430 DOI: 10.1155/2015/920618] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/24/2014] [Revised: 09/12/2014] [Accepted: 10/08/2014] [Indexed: 02/08/2023]
Abstract
Type 2 diabetes mellitus (T2DM), a chronic disease increasing rapidly worldwide, is well established as an important risk factor for various types of cancer. Although many factors impact the development of T2DM and cancer including sex, age, ethnicity, obesity, diet, physical activity levels, and environmental exposure, many epidemiological and experimental studies are gradually contributing to knowledge regarding the interrelationship between DM and cancer. The insulin resistance, hyperinsulinemia, and chronic inflammation associated with diabetes mellitus are all associated strongly with cancer. The changes in bioavailable ovarian steroid hormone that occur in diabetes mellitus (the increasing levels of estrogen and androgen and the decreasing level of progesterone) are also considered potentially carcinogenic conditions for the breast, endometrium, and ovaries in women. In addition, the interaction among insulin, insulin-like growth factors (IGFs), and ovarian steroid hormones, such as estrogen and progesterone, could act synergistically during cancer development. Here, we review the cancer-related mechanisms in T2DM, the epidemiological evidence linking T2DM and cancers in women, and the role of antidiabetic medication in these cancers.
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Oshakbayev KP, Alibek K, Ponomarev IO, Uderbayev NN, Dukenbayeva BA. Weight change therapy as a potential treatment for end-stage ovarian carcinoma. AMERICAN JOURNAL OF CASE REPORTS 2014; 15:203-11. [PMID: 24847411 PMCID: PMC4025513 DOI: 10.12659/ajcr.890229] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2012] [Accepted: 01/27/2014] [Indexed: 12/18/2022]
Abstract
Patient: Female, 41 Final Diagnosis: Ovarian carcinoma Symptoms: Ascites • hepatomegaly • weight loss Medication: — Clinical Procedure: — Specialty: Oncology
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Affiliation(s)
| | - Kenneth Alibek
- Department of Oncology, Republican Scientific Center for Emergency Medicine, Astana, Republic of Kazakhstan
| | - Igor Olegovich Ponomarev
- Department of Oncology, Republican Scientific Center for Emergency Medicine, Astana, Republic of Kazakhstan
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The dosimetric impact of single, dual, and triple tandem applicators in the treatment of intact uterine cancer. Brachytherapy 2014; 13:268-74. [DOI: 10.1016/j.brachy.2013.09.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2013] [Revised: 08/22/2013] [Accepted: 09/16/2013] [Indexed: 11/19/2022]
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Anglada-Martínez H, Riu-Viladoms G, do Pazo-Oubiña F, Molas-Ferrer G, Mangues-Bafalluy I, Codina-Jané C, Creus-Baró N. Dosing of chemotherapy in obese and cachectic patients: results of a national survey. Int J Clin Pharm 2014; 36:589-95. [DOI: 10.1007/s11096-014-9942-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2013] [Accepted: 03/25/2014] [Indexed: 10/25/2022]
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50
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Cardozo ER, Dune TJ, Neff LM, Brocks ME, Ekpo GE, Barnes RB, Marsh EE. Knowledge of obesity and its impact on reproductive health outcomes among urban women. J Community Health 2013; 38:261-7. [PMID: 22961295 DOI: 10.1007/s10900-012-9609-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
This prospective survey study assessed the knowledge of reproductive outcomes that are affected by obesity among women in an urban community. A total of 207 women attending a community fair on the south side of Chicago participated in the study. A survey assessing knowledge of BMI and of the effects of obesity on general, cardiometabolic and reproductive health outcomes was administered. Subjects ranged in age from 18 to 70 years (mean ± SD, 48.6 ± 12.9 years) and ranged in BMI from 17.3 to 52.1 kg/m(2) (mean ± SD, 31.2 ± 6.7 kg/m(2)). The following percentages of women were aware that obesity increases the risk of miscarriage (37.5 %), irregular periods (35.8 %), infertility (33.9 %), cesarean section (30.8 %), breast cancer (28.0 %), birth defects (23.7 %), stillbirth (14.1 %), and endometrial cancer (18.1 %). This study found that while women in an urban community are aware of the cardiometabolic risks associated with obesity, they demonstrate limited knowledge of the effects of obesity on reproductive outcomes. Public education is needed to increase knowledge and awareness of the reproductive consequences of obesity. Women of reproductive age may be uniquely responsive to obesity education and weight loss intervention.
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Affiliation(s)
- Eden R Cardozo
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA
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