New Study Links High Metabolic Activity of Visceral Fat to Aggressive Endometrial Cancer

Recent research presented at the 38th Annual Congress of the European Association of Nuclear Medicine (EANM'25) reveals a concerning link between the metabolic activity of visceral fat and the aggressiveness of endometrial cancer. This groundbreaking study suggests that it is not only the amount of visceral fat present that poses a risk, but also its metabolic characteristics that could determine cancer progression.

Understanding Visceral Fat

Visceral fat, located around internal organs, has long been recognized for its health implications, particularly in relation to obesity. بينما تعتبر السمنة عاملا معترفا به في خطر الإصابة بسرطان بطانة الرحم, this new research indicates that a deeper understanding of how visceral fat behaves at the metabolic level could provide a clearer picture of cancer risk.

Study Methodology

Researchers from Haukeland University Hospital and the University of Bergen conducted a thorough analysis involving PET/CT scans of 274 women diagnosed with endometrial cancer. By measuring glucose absorption in visceral fat as a marker of metabolic activity, they were able to correlate these metrics with disease severity.

The findings were staggering: women exhibiting higher metabolic activity in their visceral fat showed significantly greater likelihoods of advanced cancer stages and lymph node metastases. Jostein Sæterstøl, the lead author of the study and a Ph.D. candidate, explained, "Elevated metabolic activity in visceral fat was significantly associated with later cancer stages and the presence of metastatic lymph nodes. We found no close correlation between the volume of visceral fat and its metabolic activity, indicating that mere quantity does not fully explain disease aggressiveness."

Exploring the Mechanisms

Sæterstøl posited that the relationship between increased metabolic activity in visceral fat and aggressive cancer could arise from multiple factors. Chronic inflammation within visceral fat may lead to the release of certain cytokines and fatty acids that not only promote tumor growth but also facilitate immune evasion. Furthermore, he noted that chronic inflammation could induce insulin resistance, another risk factor in cancer progression.

Adipokines—signaling molecules produced by fat tissue—along with the interaction between adipose tissue and tumor cells, could further contribute to cancer spread, particularly to lymph nodes.

Clinical Implications

While measuring metabolic activity in visceral fat via PET/CT is not yet ready for routine clinical use due to technical challenges and variability in absorption signals, future approaches could improve risk stratification. Standardized imaging analyses, advanced quantitative PET techniques, and AI-driven methods may allow for better identification of high-risk patients, influencing treatment decisions and monitoring disease progress.

Future research will focus on refining measurement techniques to enhance precision, particularly through AI-based segmentation and exploring the ties between visceral fat metabolism and circulating biomarkers such as cytokines and hormones.

Conclusion

This study sheds light on the complex relationship between visceral fat and endometrial cancer, emphasizing that metabolic activity, combined with fat quantity, plays a crucial role in cancer aggressiveness. This nuanced understanding may pave the way for more personalized and effective treatment approaches in the future, significantly improving patient outcomes. As researchers continue to unveil the intricate dynamics of fat metabolism in relation to cancer, there is hope for better diagnostic and therapeutic strategies that can adapt to the unique profiles of individual patients.