Skip to main content
SpringerLink
Log in

Impact of Morbid Obesity on the Outcomes of Type II Endometrial Cancer: a Cohort Study

  • Original Article
  • Published:
Indian Journal of Surgical Oncology Aims and scope Submit manuscript

Abstract

Obesity has long been associated with endometrial cancer. However, there is a paucity of studies addressing the impact of morbid obesity in type II endometrial cancer on oncologic and surgical outcomes. In this study, the author retrospectively compared morbid to non-morbid obese in clinico-epidemiologic, surgical, and oncologic outcomes. Both groups were comparable as regards all clinico-epidemiologic parameters. Vaginal involvement, survival, and recurrence were also comparable between the 2 groups. Para-aortic adenopathy and treatment with preoperative therapy were the only significant predictors of DFS. Surgery is feasible with equivalent complications and oncologic outcomes in morbidly obese patients with type II endometrial cancer.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Reeves GK, Pirie K, Beral V, Green J, Spencer E, Bull D (2007) Cancer incidence and mortality in relation to body mass index in the Million Women Study: cohort study. BMJ 335(7630):1134. https://doi.org/10.1136/bmj.39367.495995.AE

    Article  PubMed  PubMed Central  Google Scholar 

  2. Calle EE, Kaaks R (2004) Overweight, obesity and cancer: epidemiological evidence and proposed mechanisms. Nat Rev Cancer 4(8):579–591. https://doi.org/10.1038/nrc1408

    Article  CAS  PubMed  Google Scholar 

  3. Renehan AG, Tyson M, Egger M, Heller RF, Zwahlen M (2008) Body-mass index and incidence of cancer: a systematic review and meta-analysis of prospective observational studies. Lancet (London, England) 371(9612):569–578. https://doi.org/10.1016/S0140-6736(08)60269-X

    Article  Google Scholar 

  4. Fambrini M, Pieralli A, Bitossi U et al (2012) Mini-laparotomy versus vaginal surgery for class II-III obese patients with early-stage endometrial cancer. Anticancer Res 32(2):707–712

    PubMed  Google Scholar 

  5. Amant F, Moerman P, Neven P, Timmerman D, Van Limbergen E, Vergote I (2007) Treatment modalities in endometrial cancer. Curr Opin Oncol 19(5):479–485. https://doi.org/10.1097/CCO.0b013e32827853c0

    Article  PubMed  Google Scholar 

  6. Santi A, Kuhn A, Gyr T et al (2010) Laparoscopy or laparotomy? A comparison of 240 patients with early-stage endometrial cancer. Surg Endosc 24(4):939–943. https://doi.org/10.1007/s00464-009-0565-5

    Article  PubMed  Google Scholar 

  7. Hecht JL, Mutter GL (2006) Molecular and pathologic aspects of endometrial carcinogenesis. J Clin Oncol Off J Am Soc Clin Oncol 24(29):4783–4791. https://doi.org/10.1200/JCO.2006.06.7173

    Article  CAS  Google Scholar 

  8. Prat J, Gallardo A, Cuatrecasas M, Catasús L (2007) Endometrial carcinoma: pathology and genetics. Pathology 39(1):72–87. https://doi.org/10.1080/00313020601136153

    Article  CAS  PubMed  Google Scholar 

  9. Bokhman JV (1983) Two pathogenetic types of endometrial carcinoma. Gynecol Oncol 15(1):10–17. https://doi.org/10.1016/0090-8258(83)90111-7

    Article  CAS  PubMed  Google Scholar 

  10. Hendrickson M, Ross J, Eifel P, Martinez A, Kempson R (1982) Uterine papillary serous carcinoma: a highly malignant form of endometrial adenocarcinoma. Am J Surg Pathol 6(2):93–108. https://doi.org/10.1097/00000478-198203000-00002

    Article  CAS  PubMed  Google Scholar 

  11. Fader AN, Nagel C, Axtell AE et al (2009) Stage II uterine papillary serous carcinoma: carboplatin/paclitaxel chemotherapy improves recurrence and survival outcomes. Gynecol Oncol 112(3):558–562. https://doi.org/10.1016/j.ygyno.2008.11.016

    Article  CAS  PubMed  Google Scholar 

  12. Fader AN, Starks D, Gehrig PA et al (2009) An updated clinicopathologic study of early-stage uterine papillary serous carcinoma (UPSC). Gynecol Oncol 115(2):244–248. https://doi.org/10.1016/j.ygyno.2009.07.030

    Article  PubMed  Google Scholar 

  13. Zhang Y, Liu Z, Yu X et al (2010) The association between metabolic abnormality and endometrial cancer: a large case-control study in China. Gynecol Oncol 117(1):41–46. https://doi.org/10.1016/j.ygyno.2009.12.029

    Article  CAS  PubMed  Google Scholar 

  14. Setiawan VW, Yang HP, Pike MC et al (2013) Type I and II endometrial cancers: have they different risk factors? J Clin Oncol Off J Am Soc Clin Oncol 31(20):2607–2618. https://doi.org/10.1200/JCO.2012.48.2596

    Article  Google Scholar 

  15. McCullough ML, Patel AV, Patel R et al (2008) Body mass and endometrial cancer risk by hormone replacement therapy and cancer subtype. Cancer Epidemiol biomarkers Prev a Publ Am Assoc Cancer Res cosponsored by Am Soc Prev Oncol 17(1):73–79. https://doi.org/10.1158/1055-9965.EPI-07-2567

    Article  CAS  Google Scholar 

  16. Bjørge T, Engeland A, Tretli S, Weiderpass E (2007) Body size in relation to cancer of the uterine corpus in 1 million Norwegian women. Int J cancer 120(2):378–383. https://doi.org/10.1002/ijc.22260

    Article  CAS  PubMed  Google Scholar 

  17. Afshin A, Forouzanfar MH, Reitsma MB et al (2017) Health effects of overweight and obesity in 195 countries over 25 years. N Engl J Med 377(1):13–27. https://doi.org/10.1056/NEJMoa1614362

    Article  PubMed  Google Scholar 

  18. Pavelka JC, Ben-Shachar I, Fowler JM et al (2004) Morbid obesity and endometrial cancer: surgical, clinical, and pathologic outcomes in surgically managed patients. Gynecol Oncol 95(3):588–592. https://doi.org/10.1016/j.ygyno.2004.07.047

    Article  PubMed  Google Scholar 

  19. Giugale LE, Di Santo N, Smolkin ME, Havrilesky LJ, Modesitt SC (2012) Beyond mere obesity: effect of increasing obesity classifications on hysterectomy outcomes for uterine cancer/hyperplasia. Gynecol Oncol 127(2):326–331. https://doi.org/10.1016/j.ygyno.2012.08.014

    Article  PubMed  Google Scholar 

  20. Santoso JT, Barton G, Riedley-Malone S, Wan JY (2012) Obesity and perioperative outcomes in endometrial cancer surgery. Arch Gynecol Obstet 285(4):1139–1144. https://doi.org/10.1007/s00404-011-2116-2

    Article  PubMed  Google Scholar 

  21. Januszek SM, Barnas E, Skret-Magierlo J et al (2019) Obesity as a risk factor of in-hospital outcomes in patients with endometrial cancer treated with traditional surgical mode. Ginekol Pol 90(10):549–556. https://doi.org/10.5603/GP.2019.0095

    Article  PubMed  Google Scholar 

  22. Akbayır O, Corbacıoglu Esmer A, Numanoglu C et al (2012) Influence of body mass index on clinicopathologic features, surgical morbidity and outcome in patients with endometrial cancer. Arch Gynecol Obstet 286(5):1269–1276. https://doi.org/10.1007/s00404-012-2431-2

    Article  PubMed  Google Scholar 

  23. Rabischong B, Larraín D, Canis M et al (2011) Long-term follow-up after laparoscopic management of endometrial cancer in the obese: a fifteen-year cohort study. J Minim Invasive Gynecol 18(5):589–596. https://doi.org/10.1016/j.jmig.2011.05.015

    Article  PubMed  Google Scholar 

  24. Erkanli S, Kayaselçuk F, Bagis T, Kuşçu E (2006) Impact of morbid obesity in surgical management of endometrial cancer: surgical morbidity, clinical and pathological aspects. Eur J Gynaecol Oncol 27(4):401–404

    CAS  PubMed  Google Scholar 

  25. Gambacorti-Passerini ZM, López-De la Manzanara Cano C, Pérez Parra C, et al. (2019) Obesity in patients with endometrial cancer: may it affect the surgical outcomes of laparoscopic approach? Obes Surg. 29(10):3285–3290. https://doi.org/10.1007/s11695-019-03986-2

  26. Watari H, Todo Y, Takeda M, Ebina Y, Yamamoto R, Sakuragi N (2005) Lymph-vascular space invasion and number of positive para-aortic node groups predict survival in node-positive patients with endometrial cancer. Gynecol Oncol 96(3):651–657. https://doi.org/10.1016/j.ygyno.2004.11.026

    Article  PubMed  Google Scholar 

  27. Lurain JR, Rice BL, Rademaker AW, Poggensee LE, Schink JC, Miller DS (1991) Prognostic factors associated with recurrence in clinical stage I adenocarcinoma of the endometrium. Obstet Gynecol 78(1):63–69

    CAS  PubMed  Google Scholar 

  28. Morrow CP, Bundy BN, Kurman RJ et al (1991) Relationship between surgical-pathological risk factors and outcome in clinical stage I and II carcinoma of the endometrium: a Gynecologic Oncology Group study. Gynecol Oncol 40(1):55–65. https://doi.org/10.1016/0090-8258(91)90086-k

    Article  CAS  PubMed  Google Scholar 

  29. Jeong N-H, Lee J-M, Lee J-K et al (2010) Role of body mass index as a risk and prognostic factor of endometrioid uterine cancer in Korean women. Gynecol Oncol 118(1):24–28. https://doi.org/10.1016/j.ygyno.2010.03.001

    Article  PubMed  Google Scholar 

  30. Modesitt SC, Tian C, Kryscio R et al (2007) Impact of body mass index on treatment outcomes in endometrial cancer patients receiving doxorubicin and cisplatin: a Gynecologic Oncology Group study. Gynecol Oncol 105(1):59–65. https://doi.org/10.1016/j.ygyno.2006.10.045

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Surgical Oncology Department, Oncology Center, Mansoura University (OCMU), Geehan Street, Mansoura, 35516, Dakahlia, Egypt

    Khaled Gaballa, Islam H. Metwally, Basel Refky, Shadi Awny, Mohamed Abdelkhalek & Mohamed Hamdy

Authors
  1. Khaled Gaballa
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Islam H. Metwally
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Basel Refky
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Shadi Awny
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Mohamed Abdelkhalek
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Mohamed Hamdy
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Islam H. Metwally.

Ethics declarations

Ethics Approval

All procedures performed in the study involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. Approval was obtained from Mansoura Faculty of Medicine Institutional Review Board (MFM-IRB) with code number R.20.12.1137.

Consent to Participate

Informed consent was obtained from the patient included in the study.

Consent for Publication

Consent for publication was obtained from the patients included in the study.

Conflict of Interest

The authors declare no competing interests.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Gaballa, K., Metwally, I.H., Refky, B. et al. Impact of Morbid Obesity on the Outcomes of Type II Endometrial Cancer: a Cohort Study. Indian J Surg Oncol 13, 453–458 (2022). https://doi.org/10.1007/s13193-022-01503-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s13193-022-01503-z

Keywords

Search

Navigation