title: Awareness of the association between obesity and peri-operative risk among newly diagnosed patients with complex atypical hyperplasia and endometrial cancer.
abstract: OBJECTIVE
  To evaluate knowledge of obesity-related peri-operative risks in with women newly diagnosed complex atypical hyperplasia and endometrial cancer.
  
  
  METHODS
  Cross sectional study of patients newly diagnosed with complex atypical hyperplasia or endometrial cancer who underwent preoperative counseling between 2011 and 2014, using a 17-item questionnaire. Obesity was defined as body mass index (BMI) of 30 kg/m2 or greater. Bivariate analysis was conducted using Pearson's Chi-Square or Fisher's Exact tests where appropriate and Mann-Whitney U for continuous variables.
  
  
  RESULTS
  Of 98 patients recruited, mean age was 58 years, 87% were obese, 83% white, and 51% had grade 1 endometrioid adenocarcinomas. Sixty-four percent of obese women reported that their physicians had discussed surgical risks related to obesity. However, 17% of obese and 42% of non-obese patients responded that they were unsure of the peri-operative risks associated with obesity. There was substantial lack of understanding among obese patients regarding their increased risks of respiratory problems (29%), thromboembolism (29%), heart attack (35%), or longer operating time (35%) and hospital stay (47%). However, obese patients were more aware of wound infection risks associated with obesity compared to their non-obese counterparts (72% vs. 31%, p=0.004).
  
  
  CONCLUSIONS
  Pre-operative counseling for obese women with newly diagnosed endometrial cancer should incorporate more focused education about obesity-related risks. They report being knowledgeable about the risks associated with their surgery, however, more than a quarter are unaware of the impact obesity has on respiratory problems, thromboembolism, wound infection, heart attack or longer operating time and hospital stay.
authors.affiliation: Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Washington University School of Medicine, and Alvin J. Siteman Cancer Center. St. Louis, MO.
authors.forename: Lindsay M
authors.initials: LM
authors.lastname: Kuroki
authors.affiliation: Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Washington University School of Medicine, and Alvin J. Siteman Cancer Center. St. Louis, MO.
authors.forename: Teri E
authors.initials: TE
authors.lastname: Benn
authors.affiliation: Division of Clinical Research, Department of Obstetrics and Gynecology, Washington University School of Medicine. St Louis, MO.
authors.forename: Jonathan L
authors.initials: JL
authors.lastname: Dukes
authors.affiliation: Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Washington University School of Medicine, and Alvin J. Siteman Cancer Center. St. Louis, MO.
authors.forename: Andrea R
authors.initials: AR
authors.lastname: Hagemann
authors.affiliation: Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Washington University School of Medicine, and Alvin J. Siteman Cancer Center. St. Louis, MO.
authors.forename: Premal H
authors.initials: PH
authors.lastname: Thaker
authors.affiliation: Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Washington University School of Medicine, and Alvin J. Siteman Cancer Center. St. Louis, MO.
authors.forename: Matthew A
authors.initials: MA
authors.lastname: Powell
authors.affiliation: Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Washington University School of Medicine, and Alvin J. Siteman Cancer Center. St. Louis, MO.
authors.forename: David G
authors.initials: DG
authors.lastname: Mutch
authors.affiliation: Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Washington University School of Medicine, and Alvin J. Siteman Cancer Center. St. Louis, MO.
authors.forename: L Stewart
authors.initials: LS
authors.lastname: Massad
authors.affiliation: Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Washington University School of Medicine, and Alvin J. Siteman Cancer Center. St. Louis, MO.
authors.forename: Israel
authors.initials: I
authors.lastname: Zighelboim
keywords: Knowledge of obesity-related surgical risks