Adjuvant treatment and survival in obese women with endometrial cancer: an international collaborative study.

Abstract

The purpose of this study was to determine the impact of patient weight on the frequency of surgical staging lymphadenectomy and pelvic radiation. Adverse effects, disease relapse, and survival outcomes were investigated. Records of 766 women who underwent surgery for presumed corpus-confined endometrial cancer were reviewed. Body mass index (BMI) was calculated to categorize women as obese (BMI, > or = 30 kg/m2) or nonobese (BMI, < 30 kg/m2). Radiation-related toxicity was scored retrospectively. Median duration of follow-up period was 38 months. Chi2, logistic regression, correlation, Kaplan-Meier, and Cox multivariate proportional hazards were used for analysis. Lymphadenectomy was completed as often in nonobese as obese women (P = .24). Adjuvant pelvic radiation treatment was administered more often in nonobese women (P = .01). Among 681 women with endometrioid histopathologic findings, 4-year cancer-related survival in obese women was 10% higher than all cause deaths, compared with 6% in nonobese women. Obesity was not a barrier to lymphadenectomy, but did influence adjuvant pelvic radiation use.