Perioperative outcomes in obese women with uterine cancer

Objectives: Obesity is a known independent risk factor for endometrial cancer that is continuing to increase in incidence throughout the United States. There is limited data on perioperative outcomes among women with endometrial cancer and obesity, especially in the era of increasing prevalence of minimally invasive surgery. We examined the association between obesity and perioperative outcomes in patients who underwent hysterectomy for uterine cancer. Methods: The National Surgical Quality Improvement Program (NSQIP) database was utilized to identify women with uterine cancer who underwent hysterectomy between the years of 2007 and 2018. Patients were classified into body mass index (BMI) groups: normal ( Results: A total of 42,075 endometrial cancer patients including 15.2% who were normal weight, 20.1% who were overweight and 64.8% who were obese were identified. Compared to normal BMI and overweight patients, obese patients were more likely to undergo minimally invasive hysterectomy (73.7% for obese, 72.0% for overweight, 71.6% for normal BMI; P=0.0018) and were less likely to have a lymph node dissection during surgery (53.3% for obese, 60.0% for overweight, 58.9% for normal BMI; P Conclusions: Obese women with endometrial cancer who undergo hysterectomy are more likely to have minimally invasive procedures and less likely to have lymph node dissections. Those with BMI ≥50 are at higher risk for severe perioperative complications and reoperation.