Body mass predicts the survival of patients with new international federation of gynecology and obstetrics stage IB1 and IB2 cervical carcinoma treated with radical hysterectomy

Finan, Michael A.; Hoffman, Mitchel S.; Chambers, Richard; Fiorica, James V.; DeCesare, Stephen; Kline, Richard; Roberts, William S.; Cavanagh, Denis

doi:10.1002/(sici)1097-0142(19980701)83:1<98::aid-cncr13>3.0.co;2-7

Cited by 20 publications

(17 citation statements)

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“…(17) The retrospective study included 229 patients over a 17-year study period. It demonstrated that a low BMI (≤ 20 kg/m 2 ) was a significant independent negative prognostic factor on survival.…”

Section: Discussionmentioning

confidence: 99%

The effects of body mass index on complications and survival outcomes in patients with cervical carcinoma undergoing curative chemoradiation therapy

Kizer

Thaker

Gao

et al. 2010

Cancer

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Background The effect of body mass index (BMI) on treatment outcomes for patients with locally advanced cervical carcinoma undergoing definitive chemoradiation is unclear. Methods This study cohort included all cervical carcinoma patients (n = 404) with stage IB1 and positive lymph nodes or stage ≥ IB2 treated at our facility from January 1998 to January 2008. Mean follow-up time was 47.2 months. BMI was calculated using the National Institute of Health online calculator. BMI categories were created according to the World Health Organization classification system. Primary outcomes were overall survival, disease free survival, and complication rate. Univariate and multivariate analyses were performed. Kaplan-Meier survival curves were generated and compared using Cox proportional hazard models. Results On multivariate analysis, when compared to normal weight subjects (18.5-24.9 kg/m2), a BMI < 18.5 kg/m2 was associated with decreased overall survival (HR 2.37, 95% CI 1.28 - 4.38, p<0.01). The 5-year overall survivals were 33%, 60%, and 68% for a BMI < 18.5 kg/m2, BMI 18.5-24.9 kg/m2, and a BMI > 24.9 kg/m2 respectively. A BMI < 18.5 kg/m2 was associated with increased risk for grade 3 or 4 complications when compared to patients with a BMI > 24.9 kg/m2 (radiation enteritis: 16.7% vs. 13.6 % p= 0.03, fistula: 11.1% vs. 8.8% p= 0.05, bowel obstruction 33.3% vs. 4.4% p< 0.001, lymphedema: 5.6% vs. 1.2% p=0.02). Conclusions Underweight patients (BMI < 18.5 kg/m2) with locally advanced cervical cancer have diminished overall survival and more complications than normal weight and obese patients.

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Section: Discussionmentioning

confidence: 99%

The effects of body mass index on complications and survival outcomes in patients with cervical carcinoma undergoing curative chemoradiation therapy

Kizer

Thaker

Gao

et al. 2010

Cancer

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“…Radiation therapy is often selected as the primary treatment in obese women with early‐stage cervical cancer because of fear of complications during surgery. In the literature, four papers have addressed the issue of the feasibility of performing a radical hysterectomy in obese patients (18–21) . These are all retrospective studies, and the definition of obesity is variable including BMI greater than 30 kg/m 2 , weight greater than 80 kg with more than 25% IBW, and more than 20% IBW.…”

Section: Cervical Cancermentioning

confidence: 99%

“…Indication for surgery was cervical cancer stages IA and IB exclusive of IB bulky for 52 obese patients (18) , stages IB1 and IB2 for 42 patients (20) , and stages IB and IIA for the remaining patients (19,21) . In every case, the surgery was performed in US facilities by an attending gynecological oncologist and described as class III radical abdominal hysterectomy; bilateral pelvic lymphadenectomy was performed on every patient, whereas para‐aortic lymphadenectomy was performed only on the patients reviewed by Levrant et al (18) and Finan et al (20) .…”

Section: Cervical Cancermentioning

confidence: 99%

The impact of obesity on surgery in gynecological oncology: a review

Papadia¹,

Ragni²,

Salom³

2006

Int J Gynecol Cancer

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Surgery represents a mainstay in the treatment of gynecological cancers. It is a common belief that operating on obese patients causes more peri- and postoperative complications than operating on nonobese patients. The surgical outcome in gynecological oncology can be evaluated by comparing intra- and postoperative complications, extent of lymphadenectomy, negativity of the specimens' margins, and percentage of optimal debulking between obese and nonobese patients affected by malignancies at the same stage. In this review, we analyze how obesity affects the feasibility of a correct oncologic procedure in case of cervical, endometrial, and ovarian cancer. We also describe the techniques that have been suggested in the literature to improve the surgical outcome on obese patients.

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“…Para-aortic lymphadenectomy turned out to be the only independent factor impacting the complication rate (20) . The intraoperative complication rate in the obese patients was 10% mainly related to hemorrhage (18,21) .…”

Section: Cervical Cancermentioning

confidence: 99%

“…30 48 265 800 23 26 infections, and dehiscences of the wound and thromboembolic events (17,20,21) . The great difference in incidence of complications in different series has to be related to the different definition of complication used in the different studies.…”

Section: Cervical Cancermentioning

confidence: 99%