Laparoscopic management of endometrial cancer according to body mass index; a Korean Outcome Research & Analysis in Gynecologic Cancers (KORAGCs) Study.
- Author:
In Ho LEE
1
;
Byoung Gie KIM
;
Jong Hyeok KIM
;
Myong Cheol LIM
;
Dae Gy HONG
;
Kwang Beom LEE
;
Jung Hun LEE
;
Seok Ju SEONG
;
Chi Heum CHO
;
Sang Wun KIM
;
Kyung Taek LIM
Author Information
1. Department of Obstetrics and Gynecology, Cheil General Hospital and Women's Healthcare Center, Kwandong University College of Medicine, Seoul, Korea.
- Publication Type:Original Article
- Keywords:
Endometrial cancer;
Obesity;
Laparosocopy;
Body mass index
- MeSH:
Body Mass Index;
Endometrial Neoplasms;
Female;
Humans;
Laparoscopy;
Length of Stay;
Lymph Nodes;
Neoplasm Metastasis;
Obesity;
Overweight;
Prospective Studies;
Random Allocation;
Thinness
- From:Korean Journal of Gynecologic Endoscopy and Minimally Invasive Surgery
2012;24(2):100-107
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
OBJECTIVE: To compare clinicopathologic characteristics and surgical outcomes of laparoscopic surgery in women with endometrial cancer according to body mass index (BMI). METHODS: From June 2009 to October 2010, prospective observational study without randomization of 159 patients treated by laparoscopic surgery from 10 hospitals nationwide. RESULTS: Patients were divided according to the WHO guidelines for Asia-Pacific populations and the distributions of BMI were as follows: 3 patients (1.9%) in underweight (BMI < 18.5 kg/m2), 50 patients (31.4%) in normal weight (BMI, 18.5-22.9 kg/m2), 45 patients (28.3%) in overweight (BMI, 23.0-24.9 kg/m2), 49 patients (30.8%) in obese (BMI, 25.0-29.9 kg/m2), and 12 patients (7.5%) in morbid obese (BMI > or = 30.0 kg/m2). Age, history of previous surgery, surgery extend, and history of previous surgery were not different between non-obese patients (BMI < 25.0 kg/m2) and obese patients (BMI > or = 25.0 kg/m2). Co-morbidities were more common in obese patients but marginally significant (23.5% vs. 37.7%, p=0.072). Four patients (2.5%) were converted to abdominal surgery because of severe adhesion. Regarding to surgical outcomes, operation time was significantly longer in obese patients (199 min vs. 235 min, p=0.013) but blood loss, lymph node yield, hospital stay, Foley removal, transfusion rate and peri-operative complication were not statistically significant. Regarding to pathologic results, there were no difference in terms of lymphovasucular space invasion, tumor grade, histologic type, lymph node metastasis and FIGO stage. CONCLUSION: Clinicopathologic characteristics and surgical outcomes does not seem to be significantly influenced by BMI except operation time. So the laparoscopic approach can be the alternative method for obese patients.
