Obesity does not affect the number of retrieved lymph nodes and the rate of intraoperative complications in gynecologic cancers

Abstract

Objective: Lymphadenectomy, in general, is a safe and well-tolerated procedure in gynecologic oncology. However, some technical difficulties may be experienced in obese women which may result in inadequate lymphadenectomy and increased complications. The purpose of this study is to retrospectively evaluate the effect of obesity on lymph node counts retrieved and complication rates observed during lymphadenectomy in gynecologic cancers. Methods: Patients with ovarian, endometrial or cervical cancers treated with initial surgery including bilateral pelvic and paraaortic lymph node dissection were grouped as non-obese and obese. These two groups were compared in terms of the number of retrieved lymph nodes and the rate of intraoperative complications directly related to lymph node dissection. Results: One hundred twenty-three patients were eligible with a mean age of 55.1 years and mean body mass index of 29.2 kg/m 2 . Fifty-nine patients were obese while 64 were non-obese. Lymph node counts obtained in different stations and in total were similar among non-obese and obese patients. Rates of lymphadenectomy-related intraoperative complications including vascular, neural, intestinal, and bladder injury were also similar in non-obese and obese patients. Conclusion:The obesity does not affect the lymph node counts and intraoperative complication rates adversely in women with gynecologic cancers. Therefore, adequate lymph node dissection should not be omitted based solely upon obesity in gynecologic oncology patients.

Body mass index and survival in patients with epithelial ovarian cancer

“…Salman et al . reported that obesity did not adversely affect lymph node counts and intraoperative complication rates in women with gynecological cancers 24 . In the present study, although more postoperative wound problems occurred in the obese group than the non‐obese group, all other surgical parameters, including the optimal debulking rate, were similar in all BMI groups.…”

To What Extent Should Para-aortic Lymphadenectomy Be Carried Out for Surgically Staged Endometrial Cancer?

“…Surgical staging clearly establishes precise margins for adjuvant therapy, but patients with endometrial cancer have variable comorbidities complicating such an extensive surgery. 4,16,17 If pelvic metastasis could be predicted, a significant number of patients would be saved from lymphadenectomy. Hence, patients proved to have pelvic metastasis should have systemic lymphadenectomy up to the renal vessels.…”

Obesity and female malignancies

“…However, it is recommended that adequate lymph node dissection should not be omitted solely on the basis of obesity [96].…”