TY - JOUR
T1 - Risk factors for lymph nodes involvement in obese women with endometrial carcinomas
AU - Wissing, Michel
AU - Mitric, Cristina
AU - Amajoud, Zainab
AU - Abitbol, Jeremie
AU - Yasmeen, Amber
AU - López-Ozuna, Vanessa
AU - How, Jeffrey
AU - Kessous, Roy
AU - Eisenberg, Neta
AU - Lau, Susie
AU - Salvador, Shannon
AU - Gotlieb, Walter H.
AU - Kogan, Liron
N1 - Publisher Copyright:
© 2019
PY - 2019/10/1
Y1 - 2019/10/1
N2 - Objective: To assess risk factors for lymph node involvement in patients with endometrial cancer and a body-mass index (BMI) ≥30 kg/m2. Materials and methods: A retrospective analysis was performed of obese patients diagnosed with endometrial carcinoma between 2007 and 2015, treated in a single center in Montreal. Preoperative variables evaluated were age, BMI, parity, and preoperative ASA score, grade, CA-125 and histology. Odds ratios (OR) and hazard ratios (HR) and their respective 95% confidence intervals (95%CI) were calculated using multivariable logistic regression and Cox proportional hazard models. Results: The study included 230 women with BMI ≥30, 223 (97.0%) had complete staging. Pelvic lymph node involvement was detected in 26 patients (11.3%). Sentinel node detection and pelvic lymph node dissection decreased with increasing BMI (adjusted OR 0.86, 95%CI 0.76–0.97 and 0.76, 95%CI 0.59–0.96, respectively, per 1 kg/m2 increment). Pelvic lymph node involvement was inversely correlated with BMI (adjusted OR 0.88, 95%CI 0.79–0.99) and present in 16/85 (18.8%), 6/56 (10.7%), and 4/82 (4.9%) of patients with a BMI of 30.0–34.9, 35.0–39.9, and ≥40.0 kg/m2, respectively. Preoperative CA-125 was associated with lymph node involvement (adjusted OR 2.77, 95%CI 1.62–4.73, per quartile increment). Conclusion: Pelvic lymph node dissection might be omitted in selected cases of morbidly obese patients with failed sentinel nodes mapping and a low CA-125.
AB - Objective: To assess risk factors for lymph node involvement in patients with endometrial cancer and a body-mass index (BMI) ≥30 kg/m2. Materials and methods: A retrospective analysis was performed of obese patients diagnosed with endometrial carcinoma between 2007 and 2015, treated in a single center in Montreal. Preoperative variables evaluated were age, BMI, parity, and preoperative ASA score, grade, CA-125 and histology. Odds ratios (OR) and hazard ratios (HR) and their respective 95% confidence intervals (95%CI) were calculated using multivariable logistic regression and Cox proportional hazard models. Results: The study included 230 women with BMI ≥30, 223 (97.0%) had complete staging. Pelvic lymph node involvement was detected in 26 patients (11.3%). Sentinel node detection and pelvic lymph node dissection decreased with increasing BMI (adjusted OR 0.86, 95%CI 0.76–0.97 and 0.76, 95%CI 0.59–0.96, respectively, per 1 kg/m2 increment). Pelvic lymph node involvement was inversely correlated with BMI (adjusted OR 0.88, 95%CI 0.79–0.99) and present in 16/85 (18.8%), 6/56 (10.7%), and 4/82 (4.9%) of patients with a BMI of 30.0–34.9, 35.0–39.9, and ≥40.0 kg/m2, respectively. Preoperative CA-125 was associated with lymph node involvement (adjusted OR 2.77, 95%CI 1.62–4.73, per quartile increment). Conclusion: Pelvic lymph node dissection might be omitted in selected cases of morbidly obese patients with failed sentinel nodes mapping and a low CA-125.
KW - BMI
KW - CA-125
KW - Endometrial cancer
KW - Lymph nodes invasion
KW - Obesity
UR - http://www.scopus.com/inward/record.url?scp=85069654745&partnerID=8YFLogxK
U2 - 10.1016/j.ygyno.2019.07.016
DO - 10.1016/j.ygyno.2019.07.016
M3 - Article
AN - SCOPUS:85069654745
SN - 0090-8258
VL - 155
SP - 27
EP - 33
JO - Gynecologic Oncology
JF - Gynecologic Oncology
IS - 1
ER -