The Impact of Obesity on Performing Lymphadenectomy and Its Outcome in Ovarian Cancer Patients

Abstract

Background: This study discusses the effect of obesity on the number of lymph nodes harvested during systematic LND and the LND-related complications in ovarian cancer patients. Methods: This retrospective study enrolled women with ovarian cancer who were consecutively subjected to open surgical resection that included systematic LND (pelvic and para-aortic) in the Oncology Center in Mansoura University (OCMU) during the period between January 2012 and June 2017. Patients were categorized according to the recommendations of World Health Organization by their BMI as non-obese (BMI < 30.0 kg/m 2) and obese (BMI ≥ 30.0 kg/m 2). Results: Seventy-seven women with ovarian cancer were enrolled in the study according to our inclusion and exclusion criteria. 43 females (55.8%) were grouped as obese and 34 (44.2%) as non-obese. Lymph nodes retrieved in total and in different stations separately (pelvic and para-aortic) were all similar among patients in both groups. LND-related intraoperative complications were observed in 8 patients (18.6%) in the obese group and 3 patients in the non-obese group (8.8%) (P = 0.347). Hospital stay was the same in the two groups with a median of 4 days (IQR 3-5). Postoperative complications occurred in 13 patients (30.2%) in the obese group and only in one patient (3%) in the non-obese group (P = 0.004). Conclusion: Obese ovarian cancer patients may safely undergo comprehensive staging involving extensive lymph node dissection in open surgeries without significant increase in the rates of intraoperative complications.

Impact of Obesity on Major Surgical Outcomes in Ovarian Cancer: A Meta-Analysis

“…It is hypothesized that operating on obese patients may cause worse surgical outcomes than operating on non-obese patients (5). But so far, accumulating studies have also been evaluating the effects of obesity on surgical outcomes in ovarian cancer, but the results have been inconsistent (4,(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16). Several studies indicated that obesity was associated with the surgical outcomes, such as optimal debulking status, postoperative complications, and return to operation room (7-11, 14, 15).…”

“…But so far, accumulating studies have also been evaluating the effects of obesity on surgical outcomes in ovarian cancer, but the results have been inconsistent ( 4 , 6 – 16 ). Several studies indicated that obesity was associated with the surgical outcomes, such as optimal debulking status, postoperative complications, and return to operation room ( 7 – 11 , 14 , 15 ). But other studies did not suggest a possible link between obesity and these major surgical outcomes in ovarian cancer patients ( 4 , 6 , 13 , 16 ).…”