New Research Links Active Visceral Fat to Increased Endometrial Cancer Aggressiveness

Recent findings presented at the 38th Annual Congress of the European Association of Nuclear Medicine highlight a significant association between the metabolic activity of visceral fat and the severity of endometrial cancer. While obesity is an established risk factor for endometrial cancer, new evidence indicates that the biochemical activity within visceral fat—rather than its mere volume—may play a crucial role in disease progression.

Researchers from Haukeland University Hospital and the University of Bergen analyzed PET/CT scans of 274 women diagnosed with endometrial cancer. They specifically measured glucose uptake in visceral fat tissue, which serves as an indicator of its metabolic activity. The study revealed that women with higher glucose uptake in visceral fat were more likely to present with advanced stages of cancer and had increased instances of lymph node metastases.

"Higher metabolic activity in visceral fat was significantly related to more advanced disease stages and the presence of metastases in lymph nodes," explained lead researcher Jostein Sæterstøl. Interestingly, the study found little correlation between the amount of visceral fat and its metabolic activity, suggesting that the biological activity of the fat may be a more critical factor in cancer severity.

The team discussed potential mechanisms underlying this link, including chronic inflammation within visceral fat that releases cytokines and fatty acids promoting tumor growth and immune evasion. Additionally, the inflammatory environment and adipokine signaling may facilitate cancer spread, especially to lymph nodes. These processes might be influenced by factors like insulin resistance, which is often induced by visceral fat-related inflammation.

Although measuring visceral fat metabolism via PET/CT is currently challenging for routine clinical use, advances such as standardized imaging techniques, artificial intelligence, and quantitative PET analysis could improve risk stratification, treatment planning, and monitoring of disease progression in the future.

Future research aims to refine these measurement methods, explore associations with tumor genomic profiles, and assess whether changes in visceral fat activity correlate with treatment response or disease evolution. Understanding these mechanisms could lead to new therapeutic strategies targeting visceral fat metabolic activity to mitigate endometrial cancer severity.