2021, Number 1
Endometrial cancer: laparoscopic staging in obese patients
Language: Spanish
References: 29
Page: 1-12
PDF size: 138.78 Kb.
ABSTRACT
Introduction: Obesity is one of the most important risk factors for endometrial cancer. There is no consensus as to an upper limit above which laparoscopic staging should not be considered. The decision is almost entirely up to the surgeon depending on and in relation to the experience acquired over the years.Objective: To describe the safety and feasibility of laparoscopic staging in endometrial cancer.
Methods: A descriptive, prospective, observational study was conducted in obese patients (n = 34) with endometrial cancer who were staged by laparoscopic surgery from February 2012 to November 2017 at the National Center for Minimal Invasive Surgery in Havana, Cuba.
Results: The mean age was 63 years. The mean body mass index was 38.6. The mean surgical time and blood loss was 215 minutes and 90.5 milliliters. The mean number of pelvic and para-aortic nodes removed was 18.0 and 3.2, respectively. No patient had complications and there was no need to convert to laparotomy. The hospital stay was 48.7 hours.
Conclusions: Laparoscopic staging of endometrial cancer in obese patients is a feasible and safe technique that reduces intraoperative and postoperative complications and hospital stay without compromising oncological results.
REFERENCES
Tinelli R, Litta P, Meir Y, Surico D, Leo L, Fusco A, et al. Advantages oflaparoscopy versus laparotomy in extremely obese women (BMI>35) with earlystageendometrial cancer: a multicenter study. Anticancer Res. 2014 May[acceso 21/05/2018];34(5):2497-502. Disponible en:http://ar.iiarjournals.org/content/34/5/2497.long.
Gunderson CC, Java J, Moore KN, Walker JL. The impact of obesity on surgicalstaging, complications, and survival with uterine cancer: A Gynecologic OncologyGroup LAP2 ancillary data study. Gynecol Oncol. 2014 Apr [acceso12/05/2018];133(1):23-7. Available from:https://www.clinicalkey.es/#!/content/journal/1-s2.0-S0090825814001012
Rabischong B, Larraín D, Canis M, Le Bouëdec G, Pomel C, Jardon K, et al.Long-term follow-up after laparoscopic management of endometrial cancer inthe obese: a fifteen-year cohort study. J Minim Invasive Gynecol. 2011 [acceso12/05/2018];18(5):589-96. Disponible en:https://www.clinicalkey.es/#!/content/journal/1-s2.0-S1553465011002548,http://www.sciencedirect.com/science/article/pii/S1553465011002548.
Díaz Ortega I, Martínez Martínez-Pinillo ÁF, Morera Pérez M, Barreras GonzálezJE, Montero León JF, Amigó de Quesada M. Estadiamiento videolaparoscópico enel adenocarcinoma de endometrio. Rev Cubana Obst Ginecol. 2014 [acceso16/05/2018];40(1):58-67. Disponible en:http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S0138-600X2014000100007.6. SEGO. Oncoguía SEGO: Cáncer de endometrio 2016. Prog Obstet Ginecol. 2017[acceso 13/04/2018];60(3):274-302. Disponible en:https://sego.es/documentos/progresos/v60-2017/n3/15_GAP_Endometrio.pdf
Calle EE, Rodriguez C, Walker-Thurmond K, Thun MJ. Overweight, obesity, andmortality from cancer in a prospectively studied cohort of U.S. adults. N Engl JMed. 2003 [acceso 09/04/2018];348(17):1625-38. Disponible en:https://www.nejm.org/doi/10.1056/NEJMoa021423?url_ver=Z39.882003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed
Zeleniuch-Jacquotte A, Akhmedkhanov A, Kato I, Koenig KL, Shore RE, Kim MY,et al. Postmenopausal endogenous oestrogens and risk of endometrial cancer:results of a prospective study. Br J Cancer. 2001 [acceso 11/04/2018];84(7):975-81.Disponible en: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2363831/.
Renehan AG, Tyson M, Egger M, Heller RF, Zwahlen M. Body-mass index andincidence of cancer: a systematic review and meta-analysis of prospectiveobservational studies. Lancet. 2008 [acceso 03/04/2018];371(9612):569-78.Disponible en: https://www.clinicalkey.es/service/content/pdf/watermarked/1-s2.0-S014067360860269X.pdf?locale=es_ES&searchIndex=
World Cancer Research Fund; American Institute for Cancer Research.Continuous Update Project Expert Report 2018. Diet, nutrition, physical activity andendometrial cancer 2013. UK: World Cancer Research Fund International; 2018[acceso 20/06/2018]. Disponible en:https://www.wcrf.org/sites/default/files/Endometrial-cancer-report.pdf.
Sheikh MA, Althouse AD, Freese KE, Soisson S, Edwards RP, Welburn S, et al. USAendometrial cancer projections to 2030: should we be concerned? Future Oncol.2014 [acceso 03/06/2018];10(16):2561-8. Disponible en:https://www.futuremedicine.com/doi/10.2217/fon.14.192?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed
Furberg AS, Thune I. Metabolic abnormalities (hypertension, hyperglycemia andoverweight), lifestyle (high energy intake and physical inactivity) and endometrialcancer risk in a Norwegian cohort. Int J Cancer. 2003 [acceso03/06/2018];104(6):669-76. Disponible en:https://onlinelibrary.wiley.com/doi/full/10.1002/ijc.10974
Cubadebate. La obesidad: Un problema de salud en Cuba [Artículo Sitio Web].La Habana, Cuba: Universidad de las Ciencias Informáticas UCI; 2018 jul 6[actualizado 20/02/2020] [acceso 20/02/2020]. Disponible en:http://www.cubadebate.cu/noticias/2018/07/06/la-obesidad-un-problema-desalud-en-cuba/#.Xk7ZoTNryUk.
Barbosa León N. Obesidad: Un problema global de salud que afecta a Cuba.Granma. La Habana, Cuba: Órgano Oficial del Comité Central del PartidoComunista de Cuba; 7 mar 2017 [acceso 20/02/2020]. Disponible en:http://www.granma.cu/cuba/2017-03-07/obesidad-un-problema-global-desalud-que-afecta-a-cuba-07-03-2017-19-03-06.
Janda M, Gebski V, Brand A, Hogg R, Jobling TW, Land R, et al. Quality of lifeafter total laparoscopic hysterectomy versus total abdominal hysterectomy forstage I endometrial cancer (LACE): a randomised trial. Lancet Oncol. 2010[acceso 16/05/2018];11(8):772-80. Disponible en:https://www.clinicalkey.es/#!/content/journal/1-s2.0-S1470204510701455
Walker JL, Piedmonte MR, Spirtos NM, Eisenkop SM, Schlaerth JB, Mannel RS,et al. Laparoscopy compared with laparotomy for comprehensive surgical stagingof uterine cancer: Gynecologic Oncology Group Study LAP2. J Clin Oncol. 2009[acceso 14/04/2018];27(32):5331-6. Disponible en:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2773219/
Bergstrom J, Aloisi A, Armbruster S, Yen T-T, Casarin J, Leitao MM, et al.Minimally invasive hysterectomy surgery rates for endometrial cancer performedat National Comprehensive Cancer Network (NCCN) Centers. Gynecol Oncol. 2018[acceso 16/05/2018];148(3):480-4. Disponible en:https://www.clinicalkey.es/#!/content/journal/1-s2.0-S0090825818300027
Colombo N, Creutzberg C, Amant F, Bosse T, Gonzalez-Martin A, LedermannJ, et al. ESMO-ESGO-ESTRO Consensus conference on endometrial cancer:diagnosis, treatment and follow-up. Int J Gynecol Cancer. 2016 [acceso13/04/2018];26(1):2-30. Disponible en:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4679344/
Todo Y, Kato H, Kaneuchi M, Watari H, Takeda M, Sakuragi N. Survival effectof para-aortic lymphadenectomy in endometrial cancer (SEPAL study): aretrospective cohort analysis. Lancet. 2010 [acceso16/05/2018];375(9721):1165-72. Disponible en:https://www.clinicalkey.es/#!/content/journal/1-s2.0-S014067360962002X
Yukiharu Todo ST, Kazuhira Okamoto ,, Katsushige Yamashiro HK.Implications of para-aortic lymph node metastasis in patients with endometrialcancer without pelvic lymph node metastasis J Gynecol Oncol. 2017 [acceso03/05/2018];28(5):10. Disponible en:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5540719/
Yoon MS, Park W, Huh SJ, Kim HJ, Kim YS, Kim YB, et al. Impact ofparaaortic lymphadenectomy for endometrial cancer with positive pelvic lymphnodes: A Korean Radiation Oncology Group study (KROG 13-17). Eur J Surg Oncol.2016 [acceso 03/04/2018];42(10):1497-505. Disponible en:https://www.clinicalkey.es/service/content/pdf/watermarked/1-s2.0-S0748798316306606.pdf?locale=es_ES&searchIndex=
Guo W, Cai J, Li M, Wang H, Shen Y. Survival benefits of pelviclymphadenectomy versus pelvic and para-aortic lymphadenectomy in patientswith endometrial cancer: A meta-analysis. Medicine (Baltimore). 2018 Jan[acceso 03/04/2018];97(1):e9520. Tongji Medical College. Disponible en:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5943115/#
Bogani G, Cromi A, Uccella S, Serati M, Casarin J, Pinelli C, et al.Perioperative and long-term outcomes of laparoscopic, open abdominal, andvaginal surgery for endometrial cancer in patients aged 80 years or older. Int JGynecol Cancer. 2014 [acceso 16/05/2018];24(5):894-900. Disponible en:https://ijgc.bmj.com/content/24/5/894