Weight-loss therapy in patients with obesity with endometrial intraepithelial neoplasia and uterine cancer.

IF 4.5 2区 医学 Q1 OBSTETRICS & GYNECOLOGY
Gynecologic oncology Pub Date : 2024-11-01 Epub Date: 2024-08-22 DOI:10.1016/j.ygyno.2024.08.003
Yukio Suzuki, Ling Chen, Koji Matsuo, Jennifer S Ferris, Elena B Elkin, Alexander Melamed, Chung Yin Kong, Nina Bickell, Evan R Myers, Laura J Havrilesky, Xiao Xu, Stephanie V Blank, William D Hazelton, Dawn L Hershman, Jason D Wright
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引用次数: 0

Abstract

Objective: Although obesity is an important risk factor for endometrial intraepithelial neoplasia (EIN) and uterine cancer, little is known about the trends in use of weight-loss therapy for patients with obesity with EIN and uterine cancer. We examined the use of weight-loss therapy among patients with obesity with EIN and uterine cancer.

Methods: The Merative MarketScan Database was used to identify patients aged 18-70 years who were obese and diagnosed with EIN or uterine cancer. The primary treatment for EIN or uterine cancer was categorized as either primary hysterectomy or hormonal therapy. Nutrition counseling, bariatric surgeries, and weight-management medications were identified as weight-loss therapy. We analyzed trends in the use of any weight-loss therapies with Cochran-Armitage tests. A multivariable logistic regression model was developed to examine factors associated with weight-loss therapy use.

Results: Overall, 15,374 patients were identified, including 5561 (36.2%) patients with EIN and obesity, and 9813 (63.8%) patients with uterine cancer and obesity. Weight-loss therapy was utilized within 1 year after diagnosis in 480 (8.6%) patients with EIN and in 802 (8.2%) patients with uterine cancer. Use of any weight-loss therapy after diagnosis of EIN increased from 4.1% in 2009 to 12.6% in 2020 (P < .001), and the use of any weight-loss therapy after diagnosis of uterine cancer increased from 4.9% in 2009 to 11.4% in 2020 (P < .001). In a multivariable regression model, younger age and patients with high comorbidity score were associated with a higher likelihood of using any weight-loss therapy.

Conclusions: Use of weight-loss therapy has increased, however there is still a significant underuse of this adjunctive therapy in patients with obesity with EIN or uterine cancer.

对患有子宫内膜上皮内瘤变和子宫癌的肥胖患者进行减肥治疗。
目的:尽管肥胖是子宫内膜上皮内瘤变(EIN)和子宫癌的重要危险因素,但人们对肥胖EIN和子宫癌患者使用减肥疗法的趋势知之甚少。我们研究了肥胖伴EIN和子宫癌患者使用减肥疗法的情况:方法:我们使用Merative MarketScan数据库来识别年龄在18-70岁之间、被诊断为EIN或子宫癌的肥胖患者。EIN或子宫癌的主要治疗方法分为原发性子宫切除术或激素治疗。营养咨询、减肥手术和体重管理药物被认定为减肥疗法。我们通过 Cochran-Armitage 检验分析了任何减肥疗法的使用趋势。我们建立了一个多变量逻辑回归模型来研究与使用减肥疗法相关的因素:共发现15374例患者,包括5561例(36.2%)EIN合并肥胖患者和9813例(63.8%)子宫癌合并肥胖患者。480例(8.6%)EIN患者和802例(8.2%)子宫癌患者在确诊后1年内使用过减肥疗法。EIN患者确诊后使用任何减肥疗法的比例从2009年的4.1%增加到2020年的12.6%(P 结论:EIN患者使用减肥疗法的比例从2009年的4.1%增加到2020年的12.6%:减肥疗法的使用率有所上升,但对于患有EIN或子宫癌的肥胖患者来说,这种辅助疗法的使用率仍明显偏低。
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来源期刊
Gynecologic oncology
Gynecologic oncology 医学-妇产科学
CiteScore
8.60
自引率
6.40%
发文量
1062
审稿时长
37 days
期刊介绍: Gynecologic Oncology, an international journal, is devoted to the publication of clinical and investigative articles that concern tumors of the female reproductive tract. Investigations relating to the etiology, diagnosis, and treatment of female cancers, as well as research from any of the disciplines related to this field of interest, are published. Research Areas Include: • Cell and molecular biology • Chemotherapy • Cytology • Endocrinology • Epidemiology • Genetics • Gynecologic surgery • Immunology • Pathology • Radiotherapy
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