Body Mass Index and Risk of Post‑Treatment Relapse in Endometrial Cancer: Evidence from an Iraqi Cross‑Sectional Cohort

• Zainab Mohamed Alaa Alhelli

  Sadr Oncology Center, Baghdad, Iraq

• Amaal Mohammed Alhelli

  Department of Water Resource Technique, Institute of Technology, Middle Technical University, Alzafaranya, Baghdad 29008, Iraq

• Aadil S Aqabi

  Medical City Blood Disease & Transplant Center, Baghdad, Iraq

Obesity has been identified as a contributing factor to the development and outcomes of endometrial cancer (EC), yet its role in post-treatment relapse remains to be elucidated. The objective of this study is to examine the association between body mass index (BMI) and the incidence of relapse among Iraqi women diagnosed with endometrial cancer (EC). A cross-sectional study was conducted at the Oncology Teaching Hospital, Baghdad Medical City (January–October 2021). A total of 75 women with histologically confirmed EC were categorized by BMI (normal weight, overweight, obese) according to the WHO criteria. Relapse was ascertained during routine follow-up and compared across BMI categories using chi-square testing. The discriminatory performance of continuous BMI was assessed using receiver operating characteristic (ROC) analysis. The results indicated that relapse occurred in 24% of normal-weight patients, 32% of overweight patients, and 60% of obese patients (χ² = 7.17; p = 0.027). The BMI exhibited moderate discriminatory capability for relapse (AUC=0.638; 95% CI 0.505–0.771; p=0.045), with an optimal threshold of 26.9 kg/m² (sensitivity 72%, specificity 48%). A higher BMI has been demonstrated to be associated with an increased risk of relapse following EC treatment. Given its modest discriminatory performance, BMI should not be considered a stand-alone prognostic marker. However, it may provide supportive information in low-resource settings. The validation of these findings in larger, multivariable studies is warranted.

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