Impact of comorbid conditions on survival in endometrial cancer

To evaluate the contribution of multiple medical comorbidities on the overall survival of endometrial cancer patients.

The study evaluated 490 endometrial cancer patients stages I to IV who were treated between 1992 and 2008 with a hysterectomy with or without radiation therapy (RT). Hazard ratios (HR) were calculated for multiple variables including: diabetes mellitus (DM), hypertension (HTN), body mass index, smoking, RT, and years of estrogen exposure and then recalculated with an adjustment for age and grade as potential confounders.

In this study, 47% of patients had HTN, 26% had DM, 11% were smokers, 64% were stage I, 39% were grade 1, and 36% received RT. The presence of DM and HTN on univariate analysis resulted in decreased survival with [HR 1.70; 95% confidence interval (CI), 1.18-2.46] and (HR 1.66; 95% CI, 1.17-2.36), respectively. On multivariate analysis after correction for stage, age, and grade, DM and HTN continued to show a reduced survival rate (HR 1.58; 95% CI, 1.07-2.33 and HR 1.51; 95% CI, 1.06-2.15, respectively). Body mass index, smoking, parity, age at menarche, and years of estrogen exposure did not affect survival before or after correction for stage, age, and grade.

In this study, DM and HTN adversely effected survival. Given the favorable survival rate for most patients with endometrial cancer, attention to comorbid conditions, and particularly DM and HTN, is becoming more relevant for its implications on current health care and policy.