Laparoscopic surgery in obese women with endometrial cancer

Abstract

Study Objective. To analyze perioperative and postoperative outcomes of laparoscopic treatment of endometrial cancer in two groups of women of different weight. Design. Prospective, multicenter clinical study (Canadian Task Force classification II-1). Setting. Three laparoscopic oncology centers. Patients. Sixty-five consecutive women with endometrial cancer, of whom 32 were not obese (weight <81.7 kg) and 33 were obese (weight≥81.7 kg, body mass index 30–40). Intervention. Laparoscopic surgery. Measurements and Main Results. Three patients (1 nonobese, 2 obese) in whom laparoscopy was converted to laparotomy were removed from data analysis. Laparoscopy in the remaining 62 (94.38%) was completed successfully. Hysterectomy and pelvic and paraaortic lymphadenectomies were performed based on tumor grade and depth of myometrial invasion. In both groups, 28 women underwent pelvic lymphadenectomy and 21 paraaortic lymph node dissection or sampling. Eight patients had metastases in pelvic or paraaortic nodes. Deep myometrial invasion over 50% was present in five obese and two nonobese women. Mean operating time was 166 and 172 minutes, respectively. The rate of major complications and conversions was higher in the obese group (8 vs 5). Conclusion. Laparoscopic surgery is feasible in obese women and may also be considered for endometrial cancer, which typically occurs in obese women.