Surgical morbidity and clinical outcomes in ovarian cancer - the role of obesity.
OBJECTIVE
To evaluate the effect of body mass index on the surgical outcomes in ovarian cancer patients. In addition, we performed a systematic review to compare our outcomes with the current literature.


METHODS
Retrospective cohort study and a systematic review of the literature.


METHODS
Gynaecology department at the Royal Cornwall Hospital Trust.


METHODS
Surgically managed stage I-IV ovarian cancer patients between September 2006 and September 2014.


METHODS
Primary and secondary outcome measures were evaluated across BMI categories; BMI <25 kg/m², BMI 25–29.9 kg/m², BMI ≥30 kg/m² and BMI ≥40 kg/m². A systematic review was performed according to Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines.


METHODS
The primary outcome measure was surgical complications. Secondary outcome measures were other intra- and postoperative outcomes.


RESULTS
Two hundred twenty-eight women were included in the study, of which 84 had a BMI <25 kg/m², 84 women had a BMI 25–29.9 kg/m², and 60 women were obese (BMI ≥30 kg/m²), 13 of whom were morbidly obese. Morbid obesity was associated with increased rates of wound complications. However, BMI did not show an association with other outcomes. In the review, an increasing BMI was associated with increased rates of wound complications and prolonged hospital stay, but did not impact other surgical outcomes.


CONCLUSIONS
Obesity is associated with increased rates of wound complications and a prolonged hospital stay, but does not appear to affect other operative outcomes including cytoreduction status and 30-day mortality. Therefore, operative management and postoperative care require a multifactorial approach to minimise adverse outcomes.
A
A
Smits
A
A
Lopes
N
N
Das
A
A
Kumar
W
W
Cliby
E
E
Smits
R
R
Bekkers
L
L
Massuger
K
K
Galaal
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D005260:Female; D006801:Humans; D008875:Middle Aged; D009765:Obesity / Q000150:complications / Q000401:mortality / Q000601:surgery*; D010051:Ovarian Neoplasms / Q000401:mortality / Q000601:surgery*; D011183:Postoperative Complications / Q000209:etiology / Q000401:mortality / Q000601:surgery*; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome