The Effect of Bariatric Surgery on Premalignant Endometrial Pathology in Morbidly Obese Patients

Bălescu, Irina; Bacalbaşa, Nicolae; Copăescu, Cătălin

doi:10.21614/chirurgia.114.6.704

Cited by 3 publications

(1 citation statement)

References 20 publications

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“…1 Insulin resistance is responsible for releasing growth factors for cellular proliferation, higher levels of interleukins, tumor necrosis factors, and adipokines causing an obesity-related proinflammatory state, and high estrogen levels through increased aromatase activity in adipose tissue are proposed as contributors to the increased risk of developing endometrial cancer. 2 Endometrial cancer is known as a hormone-dependent type of cancer. Obesity affects hormone metabolism by increasing the aromatization of androstenedione to estrone in adipose tissues and causes an increase in the circulating levels of estrogen, creating a favorable environment for tumor formation.…”

Section: Introductionmentioning

confidence: 99%

Association of Obesity and Surgery Outcomes in Patients with Endometrial Cancer: A Single-Center Analysis

Dogan

2022

Rev Bras Ginecol Obstet

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Objective Although obesity can result in high morbidity and mortality in surgical outcomes because of multiple comorbidities, determinants of outcome in obese patients who underwent endometrial cancer surgery remain unclear. The aim of this study is to assess the relationship between body mass index (BMI) and surgical outcomes in obese patients with endometrial cancer. Methods An institutional retrospective review of the demographic details, clinical characteristics, and follow-up data of 142 patients with endometrial cancer who underwent surgery during a 72-month period was performed. The patients were divided into three groups based on their BMI; patients with BMI < 25 were identified as normal weight, patients with BMI between 25 and 30 were accepted as overweight, and those with BMI ≥ 30 kg/m2 were identified as obese. The groups' demographic and clinical variables were compared. Results Of the 142 patients, 42 were in the normal weight group, 55 in the overweight group, and 45 in the obese group. Age, surgical procedures, blood loss, preoperative health status, and metastatic lymph nodes did not show a significant difference between groups. However, surgery time and total lymph nodes were higher in the obese group. (p = 0.02, p = 0.00, and p = 0.00, respectively). Common complications were anemia, fever, intestinal injury, deep vein thrombosis, fascial dehiscence and urinary infection. There was no significant difference according to the complications. Conclusion Our results indicated that higher BMI was significantly associated with a longer duration of endometrial cancer surgery. Minimally invasive surgeries and conventional laparotomy could be performed safely in obese patients.

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Section: Introductionmentioning

confidence: 99%

Association of Obesity and Surgery Outcomes in Patients with Endometrial Cancer: A Single-Center Analysis

Dogan

2022

Rev Bras Ginecol Obstet

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Does weight loss in women with obesity induce regression of endometrial hyperplasia? A systematic review

Mooney

Sumithran

2023

European Journal of Obstetrics & Gynecology and Reproductiv

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The role of bariatric and metabolic surgery in the development, diagnosis, and treatment of endometrial cancer

et al. 2022

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The obesity pandemic continues to contribute to a worsening burden of disease worldwide. The link between obesity and diseases such as diabetes, cardiovascular disease, and cancer has been well established, yet most patients living with obesity remain untreated or undertreated. Metabolic and bariatric surgery is the most effective and durable treatment for obesity, is safe, and may have a protective benefit with respect to cancer incidence. In this review, an overview of the link between obesity, metabolic surgery, and cancer is discussed with emphasis on indications for endometrial cancer, the malignancy most strongly associated with obesity. Considerable evidence from retrospective and prospective cohort studies supports a decreased risk of endometrial cancer in patients with obesity who undergo bariatric surgery compared with nonsurgical controls. Survivors of endometrial cancer are at increased risk of poor health outcomes associated with obesity, and women with endometrial cancer are more likely to die of cardiovascular disease and other obesity-related illnesses than of the malignancy itself. Recent advances in anticancer drug therapies have targeted pathways that may also be therapeutically altered with metabolic surgery. Metabolic surgery has significant potential to enter the treatment paradigm for endometrial cancer, and gynecologic oncologist visits present an opportunity to identify patients who may benefit the most.

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The Effect of Bariatric Surgery on Premalignant Endometrial Pathology in Morbidly Obese Patients

Abstract: ar putea scădea riscul de transformare malignă endometrială la pacientele cu obezitate morbidă aflate în postmenopauză. Cuvinte cheie: chirurgie bariatrică, obezitate morbidă, patologie premalignă endometrială

Cited by 3 publications

References 20 publications

Association of Obesity and Surgery Outcomes in Patients with Endometrial Cancer: A Single-Center Analysis

Association of Obesity and Surgery Outcomes in Patients with Endometrial Cancer: A Single-Center Analysis

Does weight loss in women with obesity induce regression of endometrial hyperplasia? A systematic review

The role of bariatric and metabolic surgery in the development, diagnosis, and treatment of endometrial cancer

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