928P - Prospective evaluation of glucose tolerance and insulin resistance among patients with endometrial cancer and atypical endometrial hyperplasia

Date 27 September 2014
Event ESMO 2014
Session Poster Display session
Topics Endometrial Cancer
Supportive Care
Presenter Akira Mitsuhashi
Citation Annals of Oncology (2014) 25 (suppl_4): iv305-iv326. 10.1093/annonc/mdu338
Authors A. Mitsuhashi, S. Hanawa, N. Yamamoto, T. Uehara, K. Nishikimi, S. Tate, H. Usui, M. Shozu
  • Reproductive Medicine, Graduate School of Medicine, Chiba University, 260-8670 - Chiba/JP

Abstract

Aim

Obesity and diabetes mellitus (DM) increase the risk of endometrial cancer (EC). However, the prevalence of insulin resistance (IR) and DM, including pre-DM, among Japanese patients with EC remains unclear. This study aimed to evaluate the prevalence of IR and DM, including pre-DM, among Japanese patients with EC, as well as their associations with clinical characteristics.

Methods

We prospectively enrolled patients with atypical endometrial hyperplasia (AEH) and EC who received planned treatment at Chiba University Hospital. All patients, except those with a confirmed diagnosis of DM, underwent the 75-g oral glucose tolerance test (OGTT) before treatment. IR was defined as a history of DM or a homeostasis model assessment of insulin resistance score ≥ 2.5. We compared the metabolic status of patients with type I (AEH, and endometrioid grade 1 and grade 2) and type II (endometrioid grade 3, serous carcinoma, and clear cell carcinoma) patients as well as premenopausal and postmenopausal patients.

Results

We enrolled 216 patients from March 2009 to February 2014. Among these 216 patients, 36 had a confirmed diagnosis of DM. Other than these 36 patients, abnormal OGTT results were noted in 85 patients. IR was observed in 47% of patients. A total of 161 patients (75%) had risk factors of EC such as DM/pre-DM, IR or obesity. Premenopausal patients were more frequently obese and more frequently exhibited IR than postmenopausal patients (68% versus 40%, p < 0.01; 57% versus 40%, p = 0.014). Postmenopausal patients exhibited DM and abnormal OGTT results more often than premenopausal patients; however, this difference was not statistically significant (61% versus 49%, p = 0.098). Type I EC patients were more frequently obese and more frequently exhibited IR than type II EC patients (58% versus 27%, p < 0.001; 51% versus 31%, p = 0.033). Type I EC patients exhibited DM and abnormal OGTT results less frequently than type II EC patients; however, this difference was not statistically significant (53% versus 69%, p = 0.076).

Conclusions

DM, including pre-DM, IR, and obesity were found to be highly prevalent in patients with EC and AEH. These results may support that the management of metabolic status is important for improving the survival of these patients.

Disclosure

All authors have declared no conflicts of interest.