Korean J Gynecol Endosc Minim Invasive Surg.
2012 Nov;24(2):100-107.
Laparoscopic management of endometrial cancer according to body mass index; a Korean Outcome Research & Analysis in Gynecologic Cancers (KORAGCs) Study
- Affiliations
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- 1Department of Obstetrics and Gynecology, Cheil General Hospital and Women's Healthcare Center, Kwandong University College of Medicine, Seoul, Korea.
- 2Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
- 3Department of Obstetrics and Gynecology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
- 4Center for Uterine Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Korea.
- 5Department of Obstetrics and Gynecology, Kyungpook National University School of Medicine, Daegu, Korea.
- 6Department of Obstetrics and Gynecology, Gil Medical Center, Gachon University of Medicine & Science, Incheon, Korea.
- 7Department of Obstetrics and Gynecology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
- 8Department of Obstetrics and Gynecology, CHA Gangnam Medical Center, CHA University, Seoul, Korea.
- 9Department of Obstetrics and Gynecology, Keimyung University School of Medicine, Daegu, Korea.
- 10Department of Obstetrics and Gynecology, Yonsei University College of Medicine, Seoul, Korea.
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.
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