Socioeconomic deprivation and survival in endometrial cancer: The effect of BMI.

Abstract Objectives • To determine the association between survival and socioeconomic deprivation in endometrial cancer patients • To evaluate and quantify the effect of socioeconomic deprivation on peri-operative morbidity and mortality in endometrial cancer patients Methods This is a retrospective study of surgically managed endometrial cancer patients in the Royal Cornwall Hospital Truro between January 2006 and August 2017. Patient characteristics, overall survival, recurrence free survival and intra- and postoperative outcomes were evaluated across socioeconomic deprivation groups in which socioeconomic deprivation was measured with the English Indices of Multiple Deprivation (IMD). Results In total, we identified 831 women, of which 690 were included. The median age was 66 years with a median BMI of 31 and the majority of tumours were endometrioid tumours (80.1%). For type 1 (endometrioid) tumours, better survival was seen in the least deprived patients, however this was not significant in a multivariate analysis and only age, stage and BMI remained significant. For type 2 (all other) tumours, no association between survival and socioeconomic deprivation was found and only stage was significant. However, more affluent patients had significantly higher recurrence rates. In addition, we did not find evidence of an association between intra- or post-operative complication rates and socioeconomic deprivation. Conclusion Socioeconomic deprivation is associated with survival in endometrial cancer patients, however after adjusting for confounders this association does not remain. Only age, stage and BMI are independent prognostic factors for survival. In addition, there is no evidence of association between socioeconomic deprivation and peri-operative outcomes in endometrial cancer patients.