EP546 Laparoscopy should be the preferable route in the morbidly obese endometrial cancer

Introduction/Background The risk of endometrial cancer is known to be increased with the increasing body mass index (BMI). Patients with BMI more than 40 kg/m2 are identified as morbid obese according to the World Health Organization. Morbidly obese patients are an enormous problem regarding all of their health procedures including examination, evaluation with imaging methods, surgery, increased per-operative and postoperative morbidity and complications. The laparoscopic approach had been validated for the endometrial cancer surgery in many studies. The present study aimed to investigate the adequacy and oncological safety of laparoscopy compared to laparotomy in the surgery of the morbid obese women with endometrial cancer. Methodology Archival records and pathological reports of the endometrial cancer cases who were operated and followed up in Cukurova University Gynecologic Oncology Center between January 2008 and December 2018 were retrospectively reviewed. Patients with BMI ≥40 were divided into laparoscopy and laparotomy groups. Groups were compared concerning cases9 clinic, surgical and pathological features. In addition, survival analysis of the groups were performed using Kaplan-Meier and compared with the Log-rank method. Results A total of 146 morbidly obese endometrial cancer cases with sufficient data were determined during the study period. Laparoscopic surgery was performed in 65 (44.5%) and laparotomy in 81 (55.5%) of them. Mean age was 58 years for both groups. Mean BMI of the laparoscopy and laparotomy groups was 46.1 kg/m2 and 44.3 kg/m2, respectively. No difference between groups according to the main clinical, surgical and pathological characteristics. Five-year overall survival rates were 86.6% and 83.9% in the laparoscopy and laparotomy groups (p=0.571), respectively. No difference between groups concerning to the disease free survival was noted (p=0.184). Conclusion Laparoscopic surgery do not harm the long-term oncologic outcomes of the morbidly obese endometrial cancer patients, while its short-term advantages in this special population are undeniable. Disclosure Nothing to disclose.