Obesity and perioperative outcomes in endometrial cancer surgery

Obesity is a significant risk factor in developing endometrial cancer. As obesity is becoming more endemic, we wish to evaluate the impact of obesity on perioperative outcomes in patients undergoing uterine cancer surgery.

We analyzed our prospective database on patients with endometrial cancer who underwent abdominal hysterectomy and pelvic/aortic lymphadenectomy by one gynecologic oncologist. Information regarding race, age, body mass index (BMI), lymph node counts, staging, and estimated blood loss were analyzed against patient's weight category. Weight category was divided as follows: Normal weight (BMI < 25), overweight (BMI 25 to <30), obese (BMI 30 to <35) and morbid obesity (BMI ≥ 35).

Between April 2003 and December 2009, 233 patients were recruited prospectively. This study found no difference in the number of lymph nodes harvested patient (P = 0.0539) or length of hospital stay (P = 0.4234) in patients with a normal BMI versus that of an overweight, obese, or morbidly obese. However, estimated blood loss (P = 0.01) and operative time (P = 0.0015) were greater as BMI increased. African American patients were more morbidly obese than Caucasian patients. Furthermore, younger patients tend to be more obese across all races. Finally, obesity did not affect perioperative complications (P = 0.78).

Obesity increases surgical blood loss and operative time. However, obesity does not affect length of hospital stay, number of lymph nodes harvested, or perioperative complications in uterine cancer staging surgery.