Article Text
Abstract
Introduction To evaluate the impact of obesity on surgical outcomes, adverse effects of chemotherapy, and survival outcomes among patients with epithelial ovarian cancer in the Thai population.
Methods We retrospectively reviewed the medical records of epithelial ovarian cancer patients who underwent staging laparotomy at Siriraj Hospital from January 2008 to December 2018. Patient characteristics, surgical outcomes, chemotherapy-related complications, and survival were compared between non-obese (BMI < 25.0) and obese (BMI ≥ 25) patients using the Western Pacific Regional Office (WPRO) BMI cut-off criteria.
Results Of the 444 patients initially included, 18 were excluded, leaving 426 patients for analysis, with 21.9% (n=93) in the obesity group and 78.1% (n=333) in the non-obesity group. The obesity group had a higher incidence of diabetes mellitus (P < 0.0001), hypertension (P = 0.003), and dyslipidemia (P = 0.027) than the non-obesity group. Obesity was independently associated with postoperative complications, including wound problems (adjusted OR: 6.175; 95% CI: 1.891–13.191; P<0.001) and venous thromboembolism (adjusted OR: 5.991; 95% CI: 2.848–12.605; P<0.001), but fewer event of neutropenia (P=0.002) and delays in chemotherapy administration (P=0.015). The two groups had no significant difference in progression-free survival (P = 0.135) or five-year overall survival (P = 0.923).
Conclusion/Implications Obesity does not affect survival outcomes in patients with epithelial ovarian cancer but increases the risk of postoperative complications, including wound complications and venous thromboembolism.