Baek Min-Hyun, Lee Shin-Wha, Park Jeong-Yeol, Kim Daeyeon, Kim Jong-Hyeok, Kim Yong-Man, Kim Young-Tak, Nam Joo-Hyun
Department of Obstetrics and Gynecology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
J Korean Med Sci. 2014 Nov;29(11):1536-43. doi: 10.3346/jkms.2014.29.11.1536. Epub 2014 Nov 4.
The purpose of this study was to evaluate the surgical feasibility of and survival outcome after laparoscopy in obese Korean women with endometrial cancer which has recently been increasing. We reviewed the medical records of the patients treated at our medical institution between 1999 and 2012. The patients were divided into three groups, non-obese (Body Mass Index [BMI]<25.0), overweight (BMI 25-27.99), and obese (BMI≥28.0). These patient groups were compared in terms of their clinical characteristics, treatment methods, as well as surgical and survival outcomes. In total, 55 of the 278 eligible patients were obese women. There were no differences in the three groups in terms of the proportion of patients who underwent lymphadenectomy, their cancer stage, histologic type, type of adjuvant treatment administered, intra-, post-operative, and long-term complications, operative time, number of removed lymph nodes, blood loss, and duration of hospitalization (P=0.067, 0.435, 0.757, 0.739, 0.458, 0.173, 0.076, 0.124, 0.770, 0.739, and 0.831, respectively). The Disease-Free Survival (DFS) times were 139.1 vs. 121.6 vs. 135.5 months (P=0.313), and the Overall Survival (OS) times were 145.2 vs. 124.8 vs. 139.5 months (P=0.436) for each group, respectively. Obese women with endometrial cancer can, therefore, be as safely managed using laparoscopy as women with normal BMIs.
本研究的目的是评估腹腔镜手术在近期发病率不断上升的肥胖韩国子宫内膜癌女性患者中的手术可行性及生存结局。我们回顾了1999年至2012年在我院接受治疗的患者的病历。患者被分为三组,非肥胖组(体重指数[BMI]<25.0)、超重组(BMI 25 - 27.99)和肥胖组(BMI≥28.0)。对这些患者组在临床特征、治疗方法以及手术和生存结局方面进行了比较。在278例符合条件的患者中,共有55例为肥胖女性。三组在接受淋巴结清扫术的患者比例、癌症分期、组织学类型、辅助治疗类型、术中、术后及长期并发症、手术时间、切除淋巴结数量、失血量和住院时间方面均无差异(P值分别为0.067、0.435、0.757、0.739、0.458、0.173、0.076、0.124、0.770、0.739和0.831)。每组的无病生存期(DFS)分别为139.1个月、121.6个月和135.5个月(P = 0.313),总生存期(OS)分别为145.2个月、124.8个月和139.5个月(P = 0.436)。因此,肥胖的子宫内膜癌女性患者采用腹腔镜手术治疗与BMI正常的女性患者一样安全。