Magnesium Depletion Score as a Prognostic Indicator in Endometrial Cancer: A Retrospective Cohort Study

Magnesium is essential for cellular metabolism, and its deficiency has been associated with adverse outcomes in various cancers. The MDS, which considers factors such as diuretic and proton pump inhibitor use, alcohol consumption, and kidney function, is a practical indicator of Mg deficiency. This retrospective cohort study assessed 200 patients with EC treated between 2010 and 2024 to explore the prognostic value of MDS. Patients were divided into low (0-1), intermediate (2), and high (≥3) MDS risk categories. Higher MDSs were significantly associated with older age, comorbid conditions, hypertension, diabetes, and reduced serum magnesium and vitamin D levels (all p < 0.001). Kaplan-Meier analysis revealed that patients with high MDSs experienced notably shorter overall and progression-free survival than those with lower scores. Multivariate Cox regression analysis identified age, tumor grade, lymphovascular invasion, and stage as independent prognostic factors, excluding those for MDS. These results indicate that although MDS is associated with comorbidities, biochemical deficiencies, and poorer unadjusted survival, it does not independently predict the prognosis of EC. The MDS could be a straightforward and cost-effective tool for identifying metabolically vulnerable patients, especially among the elderly, and merits further validation in prospective studies.