RISE up: Physical function in endometrial cancer survivors

Anusha Adkoli; Gisel Larios; Kelly Gunderson; Amanda Tapia; Amanda Bonikowske; Adam Shultz; Elizabeth Ingersent; Gretchen Glaser; Jessica Gorzelitz; Amanika Kumar

doi:10.1016/j.ygyno.2026.01.524

Objectives Rehab programs in cardio-oncology have shown that targeted strength training can improve cardiovascular fitness, addressing a key factor that contributes to mortality in endometrial cancer (EC) survivors. However, there is limited research on the physical function status of EC survivors; this study aims to report baseline findings from an EC survivorship exercise intervention trial for rural and underrepresented patients. Methods This is a secondary analysis of patients enrolled in RISE: remote interventions of strength training in EC, a single arm decentralized 10-week strength training behavioral intervention trial. Inclusion criteria were age 50+, history of early-stage EC (stage 1A-B, grade 1–2) without recurrence, surgery 1–5 years prior, and either rural (rural-urban commuting area codes 4–10) or Native American, Black or Hispanic descent. Patients completed baseline functional testing (2-minute step test, 30-second arm curl, 30-second chair sit-to-stand) prior to intervention as well as validated questionnaires including Patient Reported Outcomes Measurement Information System (PROMIS) short forms (pain, physical function, anxiety, emotional support, and fatigue) and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-30) survey. Patient baseline summary statistics are compared to reported norms for women aligning with the age range of our cohort. Results Eighty patients enrolled (median age 66 [IQR 60–71]), most were rural (93%) with stage IA disease (90%), average body mass index 34.4 (±7.9), and mean 3.2 (±1.7) years since surgery. Common co-morbidities include hypertension (51%), depression/anxiety (31%), hyperlipidemia (30%), and type II diabetes (20%). EC survivors exhibited poorer physical function compared to population norms. Specifically, average 30-second chair sit-to-stand (12.3 ± 4.3) was below the population norm (15.9). EC survivors also completed fewer steps on the 2-minute step test (73.8 ± 24.1) compared to population norm (90). The EC 30-second arm curl reps (19.8 ± 6.8) were consistent with normative reps (12–19). EC patients had a mean EORTC-QLQ-30 global health status (70 ± 18.5) aligning with the population average (71–76), while physical functioning (PF2) was less favorable (80.4 ± 21.7) compared to population norms (85–90). Baseline PROMIS T-scores on average indicated lower physical function (46.2 ± 9.5) and anxiety (48 ± 8), and higher pain (52.9 ± 9), emotional support (55.7 ± 8.5), and fatigue (52.3 ± 8.5) relative to the normative average of 50. Conclusions Although EC survivors in this rural and under-represented cohort had global health status scores aligning with population norms, they reported reduced physical function on two validated questionnaires. Direct physical function scores were also lower on average compared to norms in 2 of 3 measures. These findings highlight the need for targeted strength and physical function interventions in EC survivors. The RISE study will further assess changes in physical function and PROs post strength training behavioral intervention.

RISE up: Physical function in endometrial cancer survivors

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