Body mass index and the quality of life of endometrial cancer survivors-A systematic review and meta-analysis

Background. Obesity is a risk factor for developing endometrial cancer and known to negatively affect outcomes and survival. However, the association between obesity and quality of life of endometrial cancer survivor's (ECS) remains unclear. Objectives. To assess the association between body mass index (BMI) and the quality of life of endometrial cancer survivors. In addition we assessed the associations between BMI and anxiety, depression and sexual function of endometrial cancer survivors. Methods. The review was performed according to Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines, and the Cochrane Handbook for Systematic Reviews of Interventions. We performed a search of Medline (1946-2014), Embase (1980-2014), Cinahl (1981-2014), and PsycInfo (1806-2014) to identify studies that reported on the association between BMI and quality of life outcomes in endometrial cancer survivors. Results. Seven studies fulfilled the inclusion criteria, of which four studies could be included in the analysis. The four studies which included 1362 patients, showed that obese survivors had a significantly poorer physical functioning (P = 0.001, MD: -11.61, 95% CI: -18.66 to -4.55), social functioning (P = 0.01, MD: -4.37, 95% CI: -7.75 to -1.00) and role functioning (P = 0.002, MD: -5.44 95% Cl: -8.90 to -1.98) when compared to non-obese women. Emotional functioning and cognitive functioning did not show significant differences (P = 0.18, P = 0.21). Authors' conclusions. Obesity is associated with poorer quality of life outcomes in endometrial cancer survivors, including poorer physical, role and social functioning. Future research should be directed at lifestyle interventions aiming to enhance the quality of life of this group of survivors. (C) 2015 Elsevier Inc. All rights reserved.