title: Completion surgery after concomitant chemoradiation in obese women with locally advanced cervical cancer: Evaluation of toxicity and outcome measures.
abstract: BACKGROUND
  This study aims at comparing the morbidity and oncologic outcomes in normal weight, overweight, and obese women with locally advanced cervical cancers (LACC) submitted to radical surgery after chemoradiation.
  
  
  METHODS
  A review of LACC patients with body mass index (BMI) ≥ 18.5 kg/m(2) who underwent neoadjuvant chemoradiation followed by radical surgery between January 1996 and December 2010 was performed. BMI categories were created according to the World Health Organization (WHO) classification.
  
  
  RESULTS
  Two hundred sixty-eight women met the inclusion criteria: 118 (44.0%) were normal weight, 100 (37.3%) overweight and 50 (18.7%) obese. The median follow-up was 42 months. Higher BMI was associated with older age (p = 0.0041), while there were no differences among the three groups in Charlson comorbidity score, tumor characteristics, radiotherapy dosing, type of surgery, and pathological response. There were no differences among the three groups in the intraoperative and postoperative complications as well as rate of patients requiring adjuvant treatments: 21 (7.8%) patients experienced grade 3-4 toxicity, including six normal weight, 12 overweight and three obese patients (p = 0.14). Only the rate of grade 1-2 skin toxicity was higher in obese (14%) with respect to overweight (1%) and normal women (0%) (p = 0.00001). There were no differences in the five-year DFS (74%, 77%, and 84% for normal weight, overweight, and obese women, respectively, p = n.s.), and five-year OS (76%, 78%, and 78% for normal weight, overweight, and obese women, respectively, p = n.s.).
  
  
  CONCLUSIONS
  The role of obesity should not be overestimated when evaluating the chance of enrolment of LACC patients into preoperative chemoradiation protocols.
authors: Gynecologic Oncology Unit, Giovanni Paolo II Foundation, Campobasso, Italy.
authors: Francesco
authors: F
authors: Legge
authors: Pasquale A
authors: PA
authors: Margariti
authors: Alessandro
authors: A
authors: Lucidi
authors: Gabriella
authors: G
authors: Macchia
authors: Marco
authors: M
authors: Petrillo
authors: Vito
authors: V
authors: Iannone
authors: Vito
authors: V
authors: Carone
authors: Alessio G
authors: AG
authors: Morganti
authors: Giovanni
authors: G
authors: Scambia
authors: Gabriella
authors: G
authors: Ferrandina
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use; D059248:Chemoradiotherapy; D002945:Cisplatin / Q000627:therapeutic use; D018572:Disease-Free Survival; D005260:Female; D005472:Fluorouracil / Q000627:therapeutic use; D005500:Follow-Up Studies; D006801:Humans; D007044:Hysterectomy; D008197:Lymph Node Excision; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009364:Neoplasm Recurrence, Local; D009765:Obesity / Q000453:epidemiology*; D011879:Radiotherapy Dosage; D002583:Uterine Cervical Neoplasms / Q000401:mortality* / Q000628:therapy*
chemical_list: D000970:Antineoplastic Agents; D002945:Cisplatin; D005472:Fluorouracil