4.4 Article

The association of the decline in glomerular filtration rate with aggressive endometrial cancers

Journal

INTERNATIONAL UROLOGY AND NEPHROLOGY
Volume 52, Issue 1, Pages 161-168

Publisher

SPRINGER
DOI: 10.1007/s11255-019-02324-w

Keywords

Endometrial cancer; Glomerular filtration rate; Risk factors; Histology; Stage

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Purpose Most site-specific cancer incidence is increased with the decrease of glomerular filtration rate (GFR). We analyzed endometrial cancers depending on different type, staging, and histology grades. We hypothesized that patients with lower GFR levels have an increased risk for higher staging and histology grades of endometrial cancers. Methods Patients were divided into two subgroups regarding GFR; the first group with GFR < 60 ml/min and the second group with GFR > 60 ml/min and regarding different histology grades and cancer stages. Cancers were also divided by stages (1-4). Patients were followed up during 1 year through regular controls in the outpatient clinic and during that time cancer recurrence was recorded. Results GFR was the strongest predictor for higher cancer histology grade and higher cancer staging. Patients with reduced GFR had OR for higher histology grade and higher staging of 1.06 and 1.06. Traditional risk factors for endometrial cancer development were not associated with higher histology grade or higher cancer staging. Conclusion Higher staging and histology grades in patients with endometrial cancers are associated with reduced GFR. Patients with mild-to-moderate CKD had significantly higher number of cancers with higher histology grades and higher stages than patients with mild or normal GFR category. Decline in GFR was independently associated with more aggressive cancers without other well-known risk factors for endometrial cancer development like age, menopause, diabetes, and obesity.

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