Adjuvant treatment and survival in obese women with endometrial cancer: An international collaborative study

Abstract

Objective-To determine the impact of patient weight on frequency of surgical staging lymphadenectomy and pelvic radiation. Adverse effects, disease relapse, and survival outcomes were investigated.Study Design-Records of 766 women undergoing surgery for presumed corpus-confined endometrial cancer were reviewed. Body mass index (BMI) was calculated categorizing women as obese (BMI ≥ 30) or nonobese (BMI < 30). Radiation-related toxicity was retrospectively scored. Median duration of follow-up was 38 months. Chi-square, logistic regression, correlation, KaplanMeier and Cox multivariate proportional hazards were used for analysis.Results-Lymphadenectomy was completed as often in nonobese as obese women (p=0.24). Adjuvant pelvic radiation treatment was administered more often in nonobese women (p=0.01). Among 681 women with endometrioid histopathology, four-year cancer-related survival in obese women was 10 percent higher than all cause mortality, compared to 6 percent in nonobese women.Conclusion-Obesity was not a barrier to lymphadenectomy, but did influence adjuvant pelvic radiation use.CORRESPONDING AUTHOR and REPRINT REQUESTS: Vivian von Gruenigen, MD,

Effect of the percentage of body fat on surgical, clinical and pathological outcomes in women with endometrial cancer

“…In addition, those studies had a difference in complete surgical staging rates between patients with normal bodyweight and morbidly obese patients. However, another study reported that lymphadenectomy was performed in obese women as often as non‐obese patients, and medial nodal yield was significantly lower in the obese group, similar to our study …”

Chemotherapy Plus Radiation in Advanced-Stage Endometrial Cancer

“…Body mass index was compiled according to the Centers for Disease Control using officecharted height and weight to classify nonobese (G30 kg/m 2 ) or obese (Q 30 kg/m 2 ) groups and reported because of its influence on survival outcomes. 11,12 Performance status scores of 0 (fully active with restrictions) and 1 (restricted with respect to physically strenuous activity but is ambulatory and carries out light activities of daily living without restriction [eg, personal hygiene, housework, or office work]) were assessed before chemotherapy administration. Institutional review board approvals were granted before review of the 125 patients.…”

“…Four-field pelvic radiation (median dose, 4500 cGy; range, 4500Y5040 cGy) or high-dose-rate cylinder intravaginal brachytherapy (median, 2100 cGy; range, 1500Y2100 cGy) or a combination of the 2 were done according to institutional practice (Table 1). 12 …”

Obesidad y cáncer: la tormenta perfecta

“…Cinco estudios de radioterapia externa han sugerido que los resultados de la radioterapia en cáncer de próstata en pacientes obesos son inferiores. Análisis retrospectivos de pacientes tratadas por cáncer de endometrio mostraron que la mortalidad por cáncer a 4 años fue 10% mayor en obesas 43,44 .…”