Impact of obesity on surgical and oncologic outcomes in ovarian cancer
Impact of obesity on surgical and oncologic outcomes in ovarian cancer
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DOI：
10.1016/j.ygyno.2014.07.103
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发表时间：
2014-10-01
影响因子：
4.7
通讯作者：
Cliby, William A.
中科院分区：
文献类型：
--
作者：
Kumar, Amanika;Bakkum-Gamez, Jamie N.;Cliby, William A.
目标。本研究的目的是确定肥胖对晚期上皮性卵巢癌(EOC)初次减肥术(PDS)后外科和肿瘤学预后的影响。研究对象为2003年1月2日至2011年12月30日期间接受PDS治疗的IIIC/IV期EOC女性。记录患者的特征、术中和术后结果、复发情况和状态。并发症按4分手风琴分级进行分级。根据体重指数(BMI)将患者分为3组：组1-BMI=40.0 kg/m(2)。在纳入研究的620名患者中，体重1、2和3组分别为36.6%、56.9%和6.5%。体重3组是调整混杂因素后严重并发症的独立预测因素(调整后的优势比(95%CI)：3组与2组：2.93(1.38，6.20))。体重组与残留病的差异无相关性(p=0.80)。体重1组、体重2组和体重3组的90天死亡率分别为11.9%、6.7%和15.7%(P=0.049)。体重组间OS(p=0.52)或PFS(p=0.23)差异无统计学意义。BMI>；=40.0 kg/m(2)是PDS术后30天严重并发症和90天死亡率的独立预测因子，为术前咨询提供有用的EOC信息。BMI似乎不影响包括PDS残留疾病在内的长期肿瘤学结果，尽管我们在BMI的极端情况下能力有限。体重指数可能是风险调整模型和补偿策略中需要考虑的一个重要因素。(C)2014 Elsevier Inc.保留所有权利。
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 = 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. (C) 2014 Elsevier Inc. All rights reserved.