title: Long-term follow-up after laparoscopic management of endometrial cancer in the obese: a fifteen-year cohort study.
abstract: OBJECTIVE
  To assess the surgical outcomes and long-term results of laparoscopic treatment of endometrial cancer in obese patients, and compare these results with those of nonobese women.
  
  
  METHODS
  Retrospective cohort study (Canadian Task Force classification II-2).
  
  
  METHODS
  Two referral cancer centers.
  
  
  METHODS
  Fifty-two obese and 155 nonobese women with clinical stage I endometrial cancer managed by laparoscopy from 1990-2005 in two referral centers.
  
  
  METHODS
  Demographic, surgical, perioperative and pathological characteristics of obese women and nonobese women with endometrial cancer treated by laparoscopy were analyzed and then compared. Recurrence-free and overall survival was calculated by use of Kaplan-Meier method.
  
  
  RESULTS
  Median BMI of the study population was 26.2 Kg/m(2). Median BMI among obese patients was 34.2 Kg/m(2). The conversion rate was independent from the BMI of the patient (3.8% vs 4.5%, p = .80). Neither mean operative time (187.5 vs 172 min, p = .11) neither hospital stay (5.2 vs 4.9 days, p = .44) were related with BMI. Lymphadenectomy was considered not feasible in 7 obese (17%) and 8 nonobese (7%) women (p = 0.09). Fewer lymph nodes were retrieved among obese women (8 versus 11, p <.0002). No differences were found between the groups in terms of perioperative complications. Median follow-up was 69 and 71 months for the obese and nonobese, respectively (p = .59). Overall and disease-free 5-year survival rates did not differ between obese and nonobese patients (90.3% and 87.5% versus 88.5% and 89.8%, respectively).
  
  
  CONCLUSIONS
  Despite some limitations, the laparoscopic approach seems to be particularly useful for obese patients with endometrial cancer, with similar survival and recurrence rates and without any more complications compared to the nonobese population.
authors: Department of Obstetrics-Gynecology and Human Reproduction, CHU Clermont-Ferrand, CHU Estaing, Universite d' Auvergne, Clermont-Ferrand, France. brabischong@chu-clermontferrand.fr
authors: Benoit
authors: B
authors: Rabischong
authors: Demetrio
authors: D
authors: Larraín
authors: Michel
authors: M
authors: Canis
authors: Guillaume
authors: G
authors: Le Bouëdec
authors: Christophe
authors: C
authors: Pomel
authors: Kris
authors: K
authors: Jardon
authors: Fabrice
authors: F
authors: Kwiatkowski
authors: Nicolas
authors: N
authors: Bourdel
authors: Jean-Louis
authors: JL
authors: Achard
authors: Jacques
authors: J
authors: Dauplat
authors: Gerard
authors: G
authors: Mage
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D016889:Endometrial Neoplasms / Q000150:complications / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007044:Hysterectomy / Q000379:methods*; D010535:Laparoscopy / Q000379:methods*; D008197:Lymph Node Excision; D008875:Middle Aged; D009765:Obesity / Q000150:complications*; D012189:Retrospective Studies; D016896:Treatment Outcome