Chronic Stress May Contribute to Progression of Metastatic Endometrial Cancer
Neurobiological activity in the amygdala related to stress may be associated with tumor aggressiveness among postmenopausal patients with endometrial cancer.
While previous studies have reported the increased risk of tumors and promotion of tumor aggressiveness with stress, “the relationships between chronic stress and endometrial cancer remains inconclusive,” wrote study authors. As lymph node metastasis is considered one of the critical indicators of prognostic outcomes and is used to optimize treatment strategy, this study evaluated the effect of the metabolic activity of the amygdala on tumor aggressiveness, such as lymph node metastasis, among patients with endometrial cancer.
In this study, there were 161 patients newly diagnosed with endometrial cancer who had received preoperative 18F-FDG PET/CT, which was used as the means of evaluating metabolic activity of the amygdala, were recruited. Of those patients, 24 had confirmed lymph node metastasis and 137 showed no evidence of lymph node metastasis. Additionally, 105 patients were postmenopausal and 56 were premenopausal. Metabolic activity of the amygdala was calculated as the ratio of standardized uptake value of amygdala to the mean standardized uptake value of the temporal lobe.
Postmenopausal patients who had lymph node metastasis had elevated metabolic activity of the amygdala and systemic inflammation markers when compared to those without lymph node metastasis. There was also an independent association between metabolic activity of the amygdala and lymph node metastasis for postmenopausal patients, but not for premenopausal patients. There was also a more pronounced correlation between metabolic activity of the amygdala and systemic inflammation markers among postmenopausal patients than among premenopausal patients. The authors noted that “estrogen has been shown to dampen the [hypothalamic-pituitary-adrenal] axis response to stress”, therefore, “the loss of estrogen during menopause may exacerbate stress-related biological pathways that contribute to tumor aggressiveness.”
Study authors concluded that results from this study suggest “chronic stress may play a critical role in the progression of metastatic disease” particularly among postmenopausal patients with endometrial cancer and lymph node metastasis.
Source:
Ryu K-J, Kim S, Joung C, et al. Association between chronic stress-related amygdala metabolic activity and lymph node metastasis in endometrial cancer. Sci Rep. Published November 18, 2024. doi: 10.1038/s41598-024-79987-8.
