Michel Wissing1, Cristina Mitric2, Zainab Amajoud2, Jeremie Abitbol2, Amber Yasmeen3, Vanessa López-Ozuna3, Jeffrey How2, Roy Kessous4, Neta Eisenberg5, Susie Lau2, Shannon Salvador2, Walter H Gotlieb6, Liron Kogan4. 1. Division of Cancer Epidemiology, Department of Oncology, McGill University, Montreal, QC, Canada. 2. Division of Gynecologic Oncology, Jewish General Hospital, McGill University, Montreal, Quebec, Canada. 3. Segal Cancer Center, Lady Davis Institute of Medical Research, McGill University, Montreal, Quebec, Canada. 4. Division of Gynecologic Oncology, Jewish General Hospital, McGill University, Montreal, Quebec, Canada; Segal Cancer Center, Lady Davis Institute of Medical Research, McGill University, Montreal, Quebec, Canada. 5. Department of Obstetrics and Gynecology, Hôpital Maisonneuve-Rosemont, Université de Montréal, Quebec, Canada. 6. Division of Gynecologic Oncology, Jewish General Hospital, McGill University, Montreal, Quebec, Canada; Segal Cancer Center, Lady Davis Institute of Medical Research, McGill University, Montreal, Quebec, Canada. Electronic address: walter.gotlieb@mcgill.ca.
Abstract
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.
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 obesepatients 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 obesepatients with failed sentinel nodes mapping and a low CA-125.
Authors: Vanessa M López-Ozuna; Liron Kogan; Mahmood Y Hachim; Emad Matanes; Ibrahim Y Hachim; Cristina Mitric; Lauren Liu Chen Kiow; Susie Lau; Shannon Salvador; Amber Yasmeen; Walter H Gotlieb Journal: Front Oncol Date: 2021-07-07 Impact factor: 6.244
Authors: Casper Reijnen; Evangelia Gogou; Nicole C M Visser; Hilde Engerud; Jordache Ramjith; Louis J M van der Putten; Koen van de Vijver; Maria Santacana; Peter Bronsert; Johan Bulten; Marc Hirschfeld; Eva Colas; Antonio Gil-Moreno; Armando Reques; Gemma Mancebo; Camilla Krakstad; Jone Trovik; Ingfrid S Haldorsen; Jutta Huvila; Martin Koskas; Vit Weinberger; Marketa Bednarikova; Jitka Hausnerova; Anneke A M van der Wurff; Xavier Matias-Guiu; Frederic Amant; Leon F A G Massuger; Marc P L M Snijders; Heidi V N Küsters-Vandevelde; Peter J F Lucas; Johanna M A Pijnenborg Journal: PLoS Med Date: 2020-05-15 Impact factor: 11.069