Evidence map›Paper›PMID 42015911›Full record

ArticleActa obstetricia et gynecologica Scandinavica2026

Fat reduction mediates the efficacy of intensive lifestyle interventions on fertility-sparing treatment in overweight patients with endometrial cancer and intraepithelial neoplasia.

Sijia Liu, Li Li, Pengfei Wu, Lulu Wang, Qujia Gama, Manrong Wang, Jinyu Zhang, Liping Jin, Xuezhen Luo, Weiwei Shan and 1 more

Abstract read
In one paragraph

Article in Acta obstetricia et gynecologica Scandinavica, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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3 · Its place in the literature

Who cites it

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4 · The record

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5 · Who and what money

Authors and funding

11 authors.

Sijia LiuDepartment of Gynecology, Obstetrics & Gynecology Hospital of Fudan University, Shanghai, China.ORCID 0000-0002-9924-6339
Li LiDepartment of Nursing, Obstetrics & Gynecology Hospital of Fudan University, Shanghai, China.
Pengfei WuDepartment of Gynecology, Obstetrics & Gynecology Hospital of Fudan University, Shanghai, China.
Lulu WangDepartment of Gynecology, Obstetrics & Gynecology Hospital of Fudan University, Shanghai, China.
Qujia GamaDepartment of Gynecology, Obstetrics & Gynecology Hospital of Fudan University, Shanghai, China.
Manrong WangDepartment of Gynecology, Obstetrics & Gynecology Hospital of Fudan University, Shanghai, China.
Jinyu ZhangDepartment of Gynecology, Obstetrics & Gynecology Hospital of Fudan University, Shanghai, China.
Liping JinShanghai Key Lab of Female Reproductive Endocrine Related Diseases, Obstetrics & Gynecology Hospital of Fudan University, Shanghai, China.
Xuezhen LuoDepartment of Gynecology, Obstetrics & Gynecology Hospital of Fudan University, Shanghai, China.
Weiwei ShanDepartment of Gynecology, Obstetrics & Gynecology Hospital of Fudan University, Shanghai, China.
Bingyi YangDepartment of Gynecology, Obstetrics & Gynecology Hospital of Fudan University, Shanghai, China.

Funding

Obstetrics and Gynecology Hospital of Fudan University FC2021CR202Shanghai Municipal Health Commission Health Industry 20224Y0080Shanghai Municipal Health Commission Health Industry Clinical Research Youth Program 20214Y0219
6 · The paper itself

Abstract

introductionFertility-sparing treatment (FST) for endometrial cancer (EC), and its precursor, endometrial intraepithelial neoplasia (EIN), is gaining attention. However, being overweight impairs the therapeutic efficacy of FST. We analyzed the association of intensive lifestyle intervention (ILI)-based weight management with clinical outcomes in overweight patients with EC/EIN undergoing FST. MATERIAL AND

methodsThis retrospective study at the Obstetrics & Gynecology Hospital of Fudan University included overweight patients with EC/EIN who received FST. Patients were categorized into the intervention group and the control group based on their weight management approach. The primary outcomes were the complete remission (CR) rate at 24 weeks and body composition changes, including weight, body fat mass (BFM), visceral fat area (VFA), and skeletal muscle mass (SMM); the secondary outcomes were the relapse rate, pregnancy rate, and live birth rate. Cox regression models were performed and hazard ratios (HR) with 95% confidence intervals (CI) were calculated. Mediation analysis was conducted and mediated effects with proportions were calculated.

resultsA total of 141 patients were retrospectively analyzed: 97 (68.8%) cases were in the intervention group undergoing ILIs and 44 (31.2%) cases were in the control group. The intervention group demonstrated significant reductions in weight (-4.2% vs. +1.5%), BFM (-8.3% vs. +3.6%), and VFA (-6.7% vs. +3.9%) (all p < 0.001). The 24-week CR rate was higher in the intervention group (44.3% vs. 25.0%, p = 0.026), with ILIs identified as an independent protective factor (HR 2.13, 95% CI 1.08-4.22, p = 0.030). A parabolic relationship was observed between weight change and CR rate (p-nonlinear = 0.038), peaking at a 3.0% weight reduction. Patients with BFM loss (48.5% vs. 28.8%, p = 0.047) or VFA loss (51.8% vs. 27.3%, p = 0.010) presented higher CR rates. Mediation analysis revealed that both VFA and BFM partially mediated the effects of ILIs (14.2% and 19.3% of the total effect). Among patients attempting natural pregnancy, the intervention group showed a strong trend toward a higher pregnancy rate (81.8% vs. 46.2%, p = 0.066).

conclusionsILI-based weight management, particularly targeting fat reduction, is associated with enhanced FST efficacy in overweight EC/EIN patients. Our findings advocate the integration of body composition-guided ILIs into standardized FST protocols.

Indexed as

Carcinoma in SituEndometrial NeoplasmsFertility PreservationLife StyleOverweightAdultFemaleHumansPregnancyRetrospective StudiesTreatment OutcomeWeight Lossendometrial cancerendometrial intraepithelial neoplasiafertility‐sparing treatmentintensive lifestyle interventionweight management

Identifiers

PMID42015911
PMCPMC13191789

What Socratic holds

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LicenceCC BY-NC
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.