Influence of Body Mass Index on management and prognosis of women with endometrial cancer

Objective. - The aim of this study was to evaluate the outcome of surgery, postoperative morbidity and prognosis of patients with endometrial cancer in function of the body mass index (BMI). Patients and methods. - The study cohort consisted of consecutive women undergoing surgery for endometrial cancer in our institution between January 2000, and September 2012. Individual records of all patients were reviewed and analyzed. Patient BMI was categorized as underweight, normal, overweight and obese. Results. - A total of 192 patients were evaluated. Patients were followed for one to 153 months with a mean of 52.56 months. The mean BMI and the range of each of the BMI categories were 16.97 kg/m(2) (14-18), 22.97 kg/m(2) (20-24.9), 27.61 kg/m(2) (25.7-29.4), 37.34 kg/m(2) (30-71). Women with higher BMI were more frequently affected by hypertension (8.3%, 31.43%, 58.13% and 59.7% respectively, P < 0.0001) and diabetes (16.67%, 4.3%, 13.9% and 29.85% respectively, P = 0.02). Women with normal BMI had more frequently postmenopausal replacement therapy than the other categories (P = 0.0004). Surgical operative time, mean length of hospitalization in days were not significantly different among the 4 groups. In the obese group there were significantly higher peroperative blood loss (P = 0.01), more wound abces (P = 0.05), more eventration (P = 0.02) and more reinterventions for complications (P = 0.03). Patients had the same protocols of treatment (surgery and adjuvant treatment) and histological characteristics were the same between groups but obese patients had much less positive lymph nodes (P = 0.03). There were no statistically significant difference in overall 5-years survival between groups (P = 0.54) Discussion and conclusions. - Our study demonstrate a survival equivalency for obese and non-obese women even though obese women showed less positive lymph nodes. (C) 2014 Elsevier Masson SAS. All rights reserved.