Adjuvant treatment and survival in obese women with endometrial cancer: an international collaborative study.
OBJECTIVE
The purpose of this study was to determine the impact of patient weight on the frequency of surgical staging lymphadenectomy and pelvic radiation. Adverse effects, disease relapse, and survival outcomes were investigated.


METHODS
Records of 766 women who underwent surgery for presumed corpus-confined endometrial cancer were reviewed. Body mass index (BMI) was calculated to categorize women as obese (BMI, > or = 30 kg/m2) or nonobese (BMI, < 30 kg/m2). Radiation-related toxicity was scored retrospectively. Median duration of follow-up period was 38 months. Chi2, logistic regression, correlation, Kaplan-Meier, and Cox multivariate proportional hazards were used for analysis.


RESULTS
Lymphadenectomy was completed as often in nonobese as obese women (P = .24). Adjuvant pelvic radiation treatment was administered more often in nonobese women (P = .01). Among 681 women with endometrioid histopathologic findings, 4-year cancer-related survival in obese women was 10% higher than all cause deaths, compared with 6% in nonobese women.


CONCLUSIONS
Obesity was not a barrier to lymphadenectomy, but did influence adjuvant pelvic radiation use.
Martra
Francesca
F
Department of Gynecologic Oncology, University of Turin, Mauriziano Umberto I Hospital, Turin, Italy.
Kunos
Charles
C
Gibbons
Heidi
H
Zola
Paolo
P
Galletto
Luciano
L
DeBernardo
Robert
R
von Gruenigen
Vivian
V
D000368:Aged; D015992:Body Mass Index; D016022:Case-Control Studies; D002423:Cause of Death; D016889:Endometrial Neoplasms / Q000401:mortality* / Q000532:radiotherapy* / Q000601:surgery; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000379:methods; D007391:International Cooperation; D016015:Logistic Models; D008197:Lymph Node Excision / Q000706:statistics & numerical data; D008198:Lymph Nodes / Q000473:pathology*; D008875:Middle Aged; D009765:Obesity / Q000175:diagnosis / Q000401:mortality*; D011336:Probability; D016016:Proportional Hazards Models; D018714:Radiotherapy, Adjuvant; D012016:Reference Values; D012189:Retrospective Studies; D018570:Risk Assessment; D016019:Survival Analysis; D016896:Treatment Outcome