Skip to main content

Advertisement

SpringerLink
Log in

Metabolic syndrome is an independent prognostic factor for endometrial adenocarcinoma

  • Brief Research Article
  • Published:
Clinical and Translational Oncology Aims and scope Submit manuscript

Abstract

Objective

To study the association between metabolic syndrome (MS) and the prognosis of patients with endometrial adenocarcinoma.

Methods

A total of 385 patients with endometrial adenocarcinoma in the Department of Gynecologic Oncology, at the Zhejiang Cancer Hospital in China, between January 2001 and December 2008 were chosen. The deadline for the completion of follow-up was December 2013. The overall survival (OS) of the patients with MS was analyzed by the Kaplan–Meier method. Various clinical characteristics (e.g., clinical and surgical stage, vascular invasion, histological grade, tumor size, age at start of the first treatment, and lymphatic metastasis) related to the prognosis of endometrial adenocarcinoma were also evaluated.

Results

A univariate analysis demonstrated that the OS rate of the patients with endometrial adenocarcinoma with MS was significantly worse than that of the patients without MS for all 385 patients (P = 0.001). Multivariate Cox proportional hazards regression analyses showed that stage (P = 0.001), lymphatic metastasis (P = 0.021), and MS (P = 0.049) were independent prognostic factors for endometrial adenocarcinoma. Furthermore, statistical analyses demonstrated that MS was closely related to stage (P = 0.021), grade (P = 0.022), vascular invasion (P = 0.044), tumor size (P = 0.035), and lymphatic metastasis (P = 0.014) but not with age at start of the first treatment (P = 0.188). Finally, according to the univariate analysis of the OS rate of 129 cases of endometrial adenocarcinoma with MS, stage (P = 0.001), vascular invasion (P = 0.049), tumor size >2 cm (P = 0.028), lymphatic metastasis (P = 0.002), and CA19-9 value >37 U/m (P = 0.002) all showed significantly low P values for OS.

Conclusion

Metabolic syndrome is an independent prognostic factor for endometrial adenocarcinoma.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Furberg AS, Thune I. Metabolic abnormalities (hypertension, hyperglycemia and overweight), lifestyle (high energy intake and physical inactivity) and endometrial cancer risk in a Norwegian cohort. Int J Cancer. 2003;104(6):669–76.

    Article  CAS  PubMed  Google Scholar 

  2. Kim JJ, Chapman-Davis E. Role of progesterone in endometrial cancer. Semin Reprod Med. 2010;28(1):81–90.

    Article  CAS  PubMed  Google Scholar 

  3. Bjørge T, Engeland A, Tretli S, Weiderpass E. Body size in relation to cancer of the uterine corpus in 1 million Norwegian women. Int J Cancer. 2007;120(2):378–83.

    Article  PubMed  Google Scholar 

  4. Setiawan VW, Yang HP, Pike MC, McCann SE, Yu H, Xiang YB, et al. Type I and II endometrial cancers: have they different risk factors? J Clin Oncol. 2013;31(20):2607–18.

    Article  PubMed Central  PubMed  Google Scholar 

  5. Friedenreich CM, Biel RK, Lau DC, Csizmadi I, Coumeya KS, Magliocco AM, et al. Case–control study of the metabolic syndrome and metabolic risk factors for endometrial cancer. Cancer Epidemiol Biomarkers Prev. 2011;20:2384–95.

    Article  CAS  PubMed  Google Scholar 

  6. Rosato V, Zucchetto A, Bosetti C, Dal Maso L, Montella M, Pelucchi C, et al. Metabolic syndrome and endometrial cancer risk. Ann Oncol. 2011;22:884–9.

    Article  CAS  PubMed  Google Scholar 

  7. Esposito K, Chiodini P, Colao A, Lenzi A, Giugliano D. Metabolic syndrome and risk of cancer: a systematic review and meta-analysis. Diabetes Care. 2012;35(11):2402–11.

    Article  PubMed Central  PubMed  Google Scholar 

  8. Alberti KG, Zimmet P, Shaw J. Metabolic syndrome—a new world-wide definition. A consensus statement from the international diabetes federation. Diabet Med. 2006;23:469–80.

    Article  CAS  PubMed  Google Scholar 

  9. Sherman ME. Theories of endometrial carcinogenesis: a multidisciplinary approach. Mod Pathol. 2000;13(3):295–308.

    Article  CAS  PubMed  Google Scholar 

  10. Bokhman JV. Two pathogenetic types of endometrial carcinoma. Gynecol Oncol. 1983;15(1):10–7.

    Article  CAS  PubMed  Google Scholar 

  11. Emons G, Fleckenstein G, Hinney B, Huschmand A, Heyl W. Hormonal interactions in endometrial cancer. Endocr Relat Cancer. 2000;7(4):227–42.

    Article  CAS  PubMed  Google Scholar 

  12. Hecht JL, Mutter GL. Molecular and pathologic aspects of endometrial carcinogenesis. J Clin Oncol. 2006;24(29):4783–91.

    Article  CAS  PubMed  Google Scholar 

  13. Alberti KG, Eckel RH, Grundy SM, Zimmet PZ, Cleeman JI, Donato KA, et al. International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; International Association for the Study of Obesity. Harmonizing the metabolic syndrome: a joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity. Circulation. 2009;120(16):1640–5.

    Article  CAS  PubMed  Google Scholar 

  14. Zhou JR, Blackburn GL, Walker WA. Symposium introduction: metabolic syndrome and the onset of cancer. Am J Clin Nutr. 2007;86(3):s817–9.

    PubMed Central  PubMed  Google Scholar 

  15. Cowey S, Hardy RW. The metabolic syndrome: a high-risk state for cancer? Am J Pathol. 2006;169(5):1505–22.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  16. Lund Haheim L, Wisløff TF, Holme I, Nafstad P. Metabolic syndrome predicts prostate cancer in a cohort of middle-aged Norwegian men followed for 27 years. Am J Epidemiol. 2006;164(8):769–74.

    Article  CAS  PubMed  Google Scholar 

  17. StürmerT Buring JE, Lee IM, Gaziano JM, Glynn RJ. Metabolic abnormalities and risk for colorectal cancer in the physicians’ health study. Cancer Epidemiol Biomarkers Prev. 2006;15(12):2391–7.

    Article  PubMed Central  PubMed  Google Scholar 

  18. Cust AE, Kaaks R, Friedenreich C, Bonnet F, Laville M, Tjønneland A, et al. Metabolic syndrome, plasma lipid, lipoprotein and glucose levels, and endometrial cancer risk in the European Prospective Investigation into Cancer and Nutrition (EPIC). Endocr Relat Cancer. 2007;14(3):755–67.

    Article  CAS  PubMed  Google Scholar 

  19. Bjørge T, Stocks T, Lukanova A, Tretli S, Selmer R, Manjer J, et al. Metabolic syndrome and endometrial carcinoma. Am J Epidemiol. 2010;171(8):892–902.

    Article  PubMed  Google Scholar 

  20. ShouHF Ni J, Zhu T, Chen JH, Zhang X, Xu XX, et al. Association between endometrial cancer and metabolic syndrome. Zhonghua Fu Chan Ke Za Zhi. 2010;45(2):128–31.

    PubMed  Google Scholar 

  21. Gunter MJ, Hoover DR, Yu H, Wassertheil-Smoller S, Manson JE, Li J, et al. A prospective evaluation of insulin and insulin-like growth factor-I as risk factors for endometrial cancer. Cancer Epidemiol Biomarkers Prev. 2008;17(4):921–9.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  22. Cust AE, Allen NE, Rinaldi S, Dossus L, Friedenreich C, Olsen A, et al. Serum levels of C-peptide, IGFBP-1 and IGFBP-2 and endometrial cancer risk; results from the European Prospective Investigation into Cancer and Nutrition. Int J Cancer. 2007;120(12):2656–64.

    Article  CAS  PubMed  Google Scholar 

  23. Lukanova A, Zeleniuch-Jacquotte A, Lundin E, Micheli A, Arslan AA, Rinaldi S, et al. Prediagnostic levels of C-peptide, IGF-I, IGFBP -1, -2 and -3 and risk of endometrial cancer. Int J Cancer. 2004;108(2):262–8.

    Article  CAS  PubMed  Google Scholar 

  24. Calle EE, Kaaks R. Overweight, obesity and cancer: epidemiological evidence and proposed mechanisms. Nat Rev Cancer. 2004;4(8):579–91.

    Article  CAS  PubMed  Google Scholar 

  25. Rapp K, Schroeder J, Klenk J, Ulmer H, Concin H, Diem G, et al. Fasting blood glucose and cancer risk in a cohort of more than 140,000 adults in Austria. Diabetologia. 2006;49(5):945–52.

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgments

This work was supported by the Medical Science Project of Zhejiang Province (No. 2013KYB045).

Conflict of interest

All authors confirm that they have no conflicts of interest.

Author information

Author notes

    Authors and Affiliations

    1. Department of Gynecologic Oncology, Zhejiang Cancer Hospital, 38 Guangji Road, Hangzhou, 310022, People’s Republic of China

      J. Ni, T. Zhu, L. Zhao, F. Che, Y. Chen, H. Shou & A. Yu

    Authors
    1. J. Ni
      View author publications

      You can also search for this author in PubMed Google Scholar

    2. T. Zhu
      View author publications

      You can also search for this author in PubMed Google Scholar

    3. L. Zhao
      View author publications

      You can also search for this author in PubMed Google Scholar

    4. F. Che
      View author publications

      You can also search for this author in PubMed Google Scholar

    5. Y. Chen
      View author publications

      You can also search for this author in PubMed Google Scholar

    6. H. Shou
      View author publications

      You can also search for this author in PubMed Google Scholar

    7. A. Yu
      View author publications

      You can also search for this author in PubMed Google Scholar

    Corresponding authors

    Correspondence to H. Shou or A. Yu.

    Additional information

    H. Shou and A. Yu have contributed equally to this work.

    Rights and permissions

    Reprints and permissions

    About this article

    Check for updates. Verify currency and authenticity via CrossMark

    Cite this article

    Ni, J., Zhu, T., Zhao, L. et al. Metabolic syndrome is an independent prognostic factor for endometrial adenocarcinoma. Clin Transl Oncol 17, 835–839 (2015). https://doi.org/10.1007/s12094-015-1309-8

    Download citation

    • Received:

    • Accepted:

    • Published:

    • Issue Date:

    • DOI: https://doi.org/10.1007/s12094-015-1309-8

    Keywords

    Search

    Navigation