Association between body mass index, obesity, and vulvar cancer recurrence

Yossi Tzur; Angela Magri; Raanan Meyer; Melica Nourmoussavi Brodeur; Shannon Salvador; Susie Lau; Walter Gotlieb; Gabriel Levin

doi:10.1002/ijgo.16182

Association between body mass index, obesity, and vulvar cancer recurrence

Int J Gynaecol Obstet. 2025 Jan 24. doi: 10.1002/ijgo.16182. Online ahead of print.

Authors

Yossi Tzur¹, Angela Magri², Raanan Meyer³, Melica Nourmoussavi Brodeur¹, Shannon Salvador¹, Susie Lau¹, Walter Gotlieb¹, Gabriel Levin^{1

4}

Affiliations

¹ Division of Gynecologic Oncology, Jewish General Hospital, McGill University, Montreal, Quebec, Canada.
² School of Medicine, McGill University, Montreal, Quebec, Canada.
³ Division of Minimally Invasive Gynecologic Surgery, Department of Obstetrics and Gynecology, Cedars Sinai Medical Center, California, Los Angeles, USA.
⁴ The Department of Gynecologic Oncology, Hadassah Medical Center, Faculty of Medicine, Hebrew University of Jerusalem,, Jerusalem, Israel.

PMID: 39861991
DOI: 10.1002/ijgo.16182

Abstract

Objective: The objective of this paper is to study the association between obesity and tumor recurrence in patients with vulvar cancer.

Methods: This is a retrospective study including vulvar cancer patients from 2003 to 2022. Our primary outcome was progression-free survival (PFS) stratified by status of obesity, defined as body mass index (BMI) >30.0 kg/m².

Results: Overall, 48 patients were included in the study, with 32 (66.7%) diagnosed at early stages (I-II). The median BMI was 28.0 kg/m² [interquartile range 24.9-32.3 kg/m²]. There were 13 obese patients (27%), and the median follow-up time was 55 months [interquartile range 14-102]. Most patients (80%) were HPV-independent of human papilloma virus. Surgical intervention was the primary treatment modality for 88% (n = 42) of the cohort, and 26 patients (54%) received adjuvant chemoradiation. Disease recurrence was identified in 28 patients (58%). The median PFS was 68 months, and the median overall survival was 109 months. There was no difference in the median PFS between obese patients and non-obese patients (P = 0.370). In a Cox regression analysis, after adjusting for patient age, margin-free distance, and stage of disease, BMI was not associated with PFS hazard ratio 1.06 (0.99-1.12).

Conclusion: Obesity is not associated with PFS in patients with vulvar cancer, and BMI might not be considered a risk factor for recurrence.

Keywords: body mass index; obesity; progression‐free survival; recurrence; vulvar cancer.