Abdominal fat distribution in endometrial cancer: from diagnosis to follow-up
Abstract Background The objective of this study is to quantify abdominal obesity markers from computed tomography (CT) scans at primary diagnosis and follow-up in a large endometrial cancer cohort, and to assess temporal change in obesity markers in relation to surgicopathological patient characteri...
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2025-05-01
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| Online Access: | https://doi.org/10.1186/s12885-025-14155-3 |
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| author | Kristine E. Fasmer Jostein Sæterstøl Maria B. S. Ljunggren Astrid M. K. Brun Johanna M. A. Pijnenborg Kathrine Woie Camilla Krakstad Ingfrid S. Haldorsen |
| author_facet | Kristine E. Fasmer Jostein Sæterstøl Maria B. S. Ljunggren Astrid M. K. Brun Johanna M. A. Pijnenborg Kathrine Woie Camilla Krakstad Ingfrid S. Haldorsen |
| author_sort | Kristine E. Fasmer |
| collection | DOAJ |
| description | Abstract Background The objective of this study is to quantify abdominal obesity markers from computed tomography (CT) scans at primary diagnosis and follow-up in a large endometrial cancer cohort, and to assess temporal change in obesity markers in relation to surgicopathological patient characteristics and outcome. Methods Total- (TAV), subcutaneous- (SAV), visceral (VAV) abdominal fat volumes, and visceral-to-total fat percentage (VAV%) were derived from CT scans acquired in an endometrial cancer patient cohort at primary diagnosis (nprimary=293). Temporal (delta, δ) changes in CT obesity markers from primary diagnosis to follow-up were assessed for all patients with a follow-up CT 13 (7, 19) [median (interquartile range)] months after diagnosis (nfollow−up=152/293 patients). The CT obesity markers were assessed in relation to clinicopathological features and progression-free survival (PFS) using Mann-Whitney U-test, and Cox hazard ratios (HRs), respectively. Results At primary diagnosis, VAV% was the only marker significantly associated with high-risk histology (median of 33% for endometrioid endometrial carcinoma (EEC) grade 1–2, 36% for EEC grade 3 and 36% for non-endometrioid EC, p = 0.003), myometrial invasion (MI) (median of 34% for MI < 50% vs. 35% for MI ≥ 50%, p = 0.03) and lymphovascular space invasion (LVSI) (median of 34% for no LVSI vs. 36% for LVSI, p = 0.009). High VAV% (≥ 35%) also predicted poor PFS both in univariable analysis (HR = 1.8, p = 0.02), and when stratified for surgicopathological FIGO stage (HR = 3.1, p = 0.03). At follow-up, median TAV, VAV, SAV, and VAV% were significantly lower than at primary diagnosis (p < 0.001 for all). Furthermore, patients with progression had larger reductions in visceral fat compartments (δVAV=-24%, δVAV% =-3%), than patients with no progression (δVAV=-17%, δVAV%=-2%, p ≤ 0.006 for both). Conclusion Visceral abdominal obesity (high VAV%) is associated with high-risk histologic features, myometrial invasion, and poor prognosis. Furthermore, high visceral fat loss during/following therapy is associated with disease progression. |
| format | Article |
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| institution | OA Journals |
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| language | English |
| publishDate | 2025-05-01 |
| publisher | BMC |
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| spelling | doaj-art-4e8ae5c8bbdb49158c047292ad667b932025-08-20T02:31:59ZengBMCBMC Cancer1471-24072025-05-0125111210.1186/s12885-025-14155-3Abdominal fat distribution in endometrial cancer: from diagnosis to follow-upKristine E. Fasmer0Jostein Sæterstøl1Maria B. S. Ljunggren2Astrid M. K. Brun3Johanna M. A. Pijnenborg4Kathrine Woie5Camilla Krakstad6Ingfrid S. Haldorsen7Mohn Medical Imaging and Visualization Centre (MMIV), Department of Radiology, Haukeland University HospitalMohn Medical Imaging and Visualization Centre (MMIV), Department of Radiology, Haukeland University HospitalMohn Medical Imaging and Visualization Centre (MMIV), Department of Radiology, Haukeland University HospitalMohn Medical Imaging and Visualization Centre (MMIV), Department of Radiology, Haukeland University HospitalDepartment of Obstetrics and Gynecology, Radboud university medical centerDepartment of Obstetrics and Gynaecology, Haukeland University HospitalDepartment of Obstetrics and Gynaecology, Haukeland University HospitalMohn Medical Imaging and Visualization Centre (MMIV), Department of Radiology, Haukeland University HospitalAbstract Background The objective of this study is to quantify abdominal obesity markers from computed tomography (CT) scans at primary diagnosis and follow-up in a large endometrial cancer cohort, and to assess temporal change in obesity markers in relation to surgicopathological patient characteristics and outcome. Methods Total- (TAV), subcutaneous- (SAV), visceral (VAV) abdominal fat volumes, and visceral-to-total fat percentage (VAV%) were derived from CT scans acquired in an endometrial cancer patient cohort at primary diagnosis (nprimary=293). Temporal (delta, δ) changes in CT obesity markers from primary diagnosis to follow-up were assessed for all patients with a follow-up CT 13 (7, 19) [median (interquartile range)] months after diagnosis (nfollow−up=152/293 patients). The CT obesity markers were assessed in relation to clinicopathological features and progression-free survival (PFS) using Mann-Whitney U-test, and Cox hazard ratios (HRs), respectively. Results At primary diagnosis, VAV% was the only marker significantly associated with high-risk histology (median of 33% for endometrioid endometrial carcinoma (EEC) grade 1–2, 36% for EEC grade 3 and 36% for non-endometrioid EC, p = 0.003), myometrial invasion (MI) (median of 34% for MI < 50% vs. 35% for MI ≥ 50%, p = 0.03) and lymphovascular space invasion (LVSI) (median of 34% for no LVSI vs. 36% for LVSI, p = 0.009). High VAV% (≥ 35%) also predicted poor PFS both in univariable analysis (HR = 1.8, p = 0.02), and when stratified for surgicopathological FIGO stage (HR = 3.1, p = 0.03). At follow-up, median TAV, VAV, SAV, and VAV% were significantly lower than at primary diagnosis (p < 0.001 for all). Furthermore, patients with progression had larger reductions in visceral fat compartments (δVAV=-24%, δVAV% =-3%), than patients with no progression (δVAV=-17%, δVAV%=-2%, p ≤ 0.006 for both). Conclusion Visceral abdominal obesity (high VAV%) is associated with high-risk histologic features, myometrial invasion, and poor prognosis. Furthermore, high visceral fat loss during/following therapy is associated with disease progression.https://doi.org/10.1186/s12885-025-14155-3Endometrial neoplasmsComputed tomographyObesityAdiposityIntra-abdominal fat |
| spellingShingle | Kristine E. Fasmer Jostein Sæterstøl Maria B. S. Ljunggren Astrid M. K. Brun Johanna M. A. Pijnenborg Kathrine Woie Camilla Krakstad Ingfrid S. Haldorsen Abdominal fat distribution in endometrial cancer: from diagnosis to follow-up BMC Cancer Endometrial neoplasms Computed tomography Obesity Adiposity Intra-abdominal fat |
| title | Abdominal fat distribution in endometrial cancer: from diagnosis to follow-up |
| title_full | Abdominal fat distribution in endometrial cancer: from diagnosis to follow-up |
| title_fullStr | Abdominal fat distribution in endometrial cancer: from diagnosis to follow-up |
| title_full_unstemmed | Abdominal fat distribution in endometrial cancer: from diagnosis to follow-up |
| title_short | Abdominal fat distribution in endometrial cancer: from diagnosis to follow-up |
| title_sort | abdominal fat distribution in endometrial cancer from diagnosis to follow up |
| topic | Endometrial neoplasms Computed tomography Obesity Adiposity Intra-abdominal fat |
| url | https://doi.org/10.1186/s12885-025-14155-3 |
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