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Impact of obesity on surgical and oncologic outcomes in ovarian cancer.

Abstract：

OBJECTIVES:The aim of this study is to determine the impact of obesity on surgical and oncologic outcomes after primary debulking surgery (PDS) in advanced epithelial ovarian cancer (EOC). METHODS:Women with stage IIIC/IV EOC who underwent PDS with curative intent between 1/2/2003 and 12/30/2011 were included. Patient characteristics, intraoperative and postoperative outcomes, recurrence and status were abstracted. Complications were graded according to the 4-point Accordion classification. For analyses, patients were divided into three groups according to body mass index (BMI): group 1-BMI <25.0 kg/m(2); group 2-BMI 25.0-39.9 kg/m(2); and group 3-BMI ≥40.0 kg/m(2). RESULTS:Of the 620 patients included in the study, 36.6%, 56.9%, and 6.5% were in weight groups 1, 2, and 3, respectively. Weight group 3 was an independent predictor of severe complications after adjusting for confounders (adjusted odds ratio (95% CI): 2.93 (1.38, 6.20) for group 3 vs. group 2). Weight group was not associated with differences in residual disease (p=0.80). The 90-day mortality rates were 11.9%, 6.7%, and 15.7%, respectively, in weight group 1, 2, and 3 (p=0.049 unadjusted, p=0.01 adjusted). There was no difference in OS (p=0.52) or PFS (p=0.23) between weight groups. CONCLUSIONS:BMI ≥40.0 kg/m(2) is an independent predictor of severe 30-day postoperative morbidity and 90-day mortality after PDS for EOC-information useful in preoperative counseling. BMI does not appear to impact long-term oncologic outcomes including residual disease at PDS, although we had limited power at the extremes of BMI. BMI may be an important factor to consider in risk-adjustment models and reimbursement strategies.

journal_name

Gynecol Oncol

journal_title

Gynecologic oncology

authors

Kumar A,Bakkum-Gamez JN,Weaver AL,McGree ME,Cliby WA

doi

10.1016/j.ygyno.2014.07.103

subject

Has Abstract

pub_date

2014-10-01 00:00:00

pages

19-24

issue

1

eissn

0090-8258

issn

1095-6859

pii

S0090-8258(14)01226-8

journal_volume

135

pub_type

杂志文章

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