Radical hysterectomy for cervical cancer in obese women. Obstet Gynecol 2000 Nov;96(5 Pt 1):727-31
Date
10/24/2000Pubmed ID
11042308DOI
10.1016/s0029-7844(00)01027-9Scopus ID
2-s2.0-0033787403 (requires institutional sign-in at Scopus site) 20 CitationsAbstract
OBJECTIVE: To estimate the morbidity, adequacy of surgery, and survival of obese women undergoing radical hysterectomy and pelvic lymphadenectomy.
METHODS: Patients with stage I and IIa cervical cancer and a body mass index (BMI) over 30 kg/m(2) and absolute weight greater than 85 kg explored with the intent for radical hysterectomy between 1986 and 1998 were identified. Patient characteristics, surgical, pathologic, and follow-up data were extracted and survival curves were generated.
RESULTS: Forty-eight obese women were identified who were explored for radical hysterectomy and pelvic lymph node dissection. The median BMI was 36 kg/m(2), and the median weight was 95 kg. Thirty-five patients (73%) had stage Ib1 disease. Despite the obesity of the study group, none had severe comorbidity. The procedure was completed in 46 patients, and abandoned in two because of metastatic disease. For patients undergoing radical hysterectomy and pelvic lymph node dissection, median blood loss was 800 mL. No patient developed fistulas. Residual tumor was present in 26 (57%) hysterectomy specimens, and margins were without disease in 45 specimens (98%). A median of 26 pelvic lymph nodes were obtained per procedure, and six patients (13%) had positive nodes. Five-year overall and disease-free survival are 84% (95% confidence interval [CI] 70.9, 97.5) and 80% (95% CI 65.2, 93.8), respectively, at a median follow-up of 36 months.
CONCLUSION: In this carefully selected obese group, we demonstrate that radical hysterectomy and pelvic lymph node dissection can be performed with adequate surgical resection, acceptable morbidity, and excellent survival.
Author List
Cohn DE, Swisher EM, Herzog TJ, Rader JS, Mutch DGAuthor
Janet Sue Rader MD Chair, Professor in the Obstetrics and Gynecology department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AdultAged
Carcinoma, Squamous Cell
Disease-Free Survival
Female
Humans
Hysterectomy
Lymph Node Excision
Middle Aged
Missouri
Morbidity
Obesity
Pelvis
Survival Analysis
Treatment Outcome
Uterine Cervical Neoplasms