Impact of severe obesity in the management of patients with high-risk endometrial cancer: A FRANCOGYN study

Simon, Ombline; Dion, Ludivine; Timoh, Krystel Nyangoh; Dupré, Pierre François; Azaïs, Henri; Bendifallah, Sofiane; Touboul, Cyril; Dabi, Yohann; Graesslin, Olivier; Raimond, Émilie; Costaz, Hélène; Kerbage, Yohan; Huchon, Cyrille; Mimoun, Camille; Koskas, Martin; Akladios, Chérif; Lecointre, Lise; Canlorbe, Geoffroy; Chauvet, Pauline; Ouldamer, Lobna; Lévèque, Jean; Lavoué, Vincent

doi:10.1016/j.jogoh.2022.102429

Cited by 3 publications

(2 citation statements)

References 36 publications

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“…Another recent meta-analysis of 11 cohort studies by the Epidemiology of Endometrial Cancer Consortium, with 14,859 case and 40,895 controls, found a positive correlation of obesity in adulthood (OR 2.85, 95% CI 2.47-3.29) and early adulthood (OR 1.26, 95% CI 1.06-1.50) with the risk of endometrial cancer [96]. These outcomes seem to be generally universal across different ethnic groups, regarding both clinical metrics (BMI, waist circumference) and endometrial cancer-related biomarkers (IGF-1, leptin, adiponectin, IL-1, IL-6) [89], [97]- [100]. Additionally, Wise et al, in a meta-analysis of 3 case-control studies, found that a BMI ≥30 Kg/m 2 is significantly associated with endometrial cancer in premenopausal women, warranting increased awareness in this age group regarding the beneficial role of losing weight for potentially preventing the manifestation of endometrial cancer [101].…”

Section: Endometrial Cancermentioning

confidence: 99%

The Effectiveness of Metabolic Bariatric Surgery in Preventing Gynecologic Cancer - from Pathophysiology to Clinical Outcomes

Machairiotis,

Pantelis,

Potiris

et al. 2024

J. Cancer

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Obesity and cancer represent two pandemics of current civilization, the progression of which has followed parallel trajectories. To time, thirteen types of malignancies have been recognized as obesity-related cancers, including breast (in postmenopausal women), endometrial, and ovarian cancer. Pathophysiologic mechanisms that connect the two entities include insulin resistance, adipokine imbalance, increased peripheral aromatization and estrogen levels, tissue hypoxia, and disrupted immunity in the cellular milieu. Beyond the connection of obesity to carcinogenesis at a molecular and cellular level, clinicians should always be cognizant of the fact that obesity might have secondary impacts on the diagnosis and treatment of gynecologic cancer, including limited access to effective screening programs, resistance to chemotherapy and targeted therapies, persisting lymphedema, etc. Metabolic bariatric surgery represents an attractive intervention not only for decreasing the risk of carcinogenesis in high-risk women living with obesity but most importantly as a measure to improve disease-specific and overall survival in patients with diagnosed obesity-related gynecologic malignancies. The present narrative review summarizes current evidence on the underlying pathophysiologic mechanisms, the clinical data, and the potential applications of metabolic bariatric surgery in all types of gynecologic cancer, including breast, endometrial, ovarian, cervical, vulvar, and vaginal.

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Section: Endometrial Cancermentioning

confidence: 99%

The Effectiveness of Metabolic Bariatric Surgery in Preventing Gynecologic Cancer - from Pathophysiology to Clinical Outcomes

Machairiotis,

Pantelis,

Potiris

et al. 2024

J. Cancer

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“…Cervical injection of tracers has been recognized as a credible approach for successful SLN mapping, which is widely used for early detection of low-risk EC [10]. Recent studies increasingly focused on the application of SLN biopsy in patients with high-risk EC [4,11,12]. Despite its safety and e cacy in primary studies, more studies are needed.…”

Section: Introductionmentioning

confidence: 99%

Comparison of sentinel lymph node distribution and lymphatic drainage pathway between high- and low-risk endometrial cancers

Chen

Liang

et al. 2023

Arch Gynecol Obstet

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This study aimed to compare the distribution and drainage pathway of sentinel lymph nodes between high-and low-risk endometrial cancers. MethodsIn total, 429 patients with endometrial cancer who underwent sentinel lymph node biopsy in Peking University People's Hospital from July 2015 to April 2022 were retrospectively enrolled. There were 148 patients in the high-risk group and 281 patients in the low-risk group. ResultsThe unilateral and bilateral detection rates of sentinel lymph nodes were 86.5% and 55.9%, respectively.The highest detection rate was achieved in the subgroup with a combined use of Indocyanine green (ICG) and Carbon nanoparticles (CNP) (94.9% for unilateral detection and 66.7% for bilateral detection). The upper paracervical pathway (UPP) was detected in 93.3% of cases in the high-risk group and 96.0% of cases in the low-risk group (p = 0.261). The lower paracervical pathway (LPP) was detected in 10.0% of cases in the high-risk group and 17.9% of cases in the low-risk group (p = 0.048). Remarkably increased detection rates of SLN in the common iliac (7.5%) and para-aortic or precaval areas (2.9%) were observed in the high-risk group. In contrast, a markedly decreased detection rate of SLN in the internal iliac area (1.9%) was observed in the high-risk group. ConclusionThe combined use of ICG and CNP improved the bilateral detection rate of SLN in the high-risk group. The detection of UPP is important for both high-risk and low-risk cases, while LPP detection plays a more important role in the low-risk group. Lymphadenectomy in the common iliac and para-aortic or precaval areas is essential for patients with high-risk EC. Removal of internal iliac lymph nodes is essential for patients with low-risk EC, in case of ineffective SLN mapping.

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Comparison of sentinel lymph node distribution and lymphatic drainage pathway between high- and low-risk endometrial cancers

Chen

Liaing²,

He³

et al. 2023

Preprint

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Purpose This study aimed to compare the distribution and drainage pathway of sentinel lymph nodes between high- and low-risk endometrial cancers. Methods In total, 429 patients with endometrial cancer who underwent sentinel lymph node biopsy in Peking University People’s Hospital from July 2015 to April 2022 were retrospectively enrolled. There were 148 patients in the high-risk group and 281 patients in the low-risk group. Results The unilateral and bilateral detection rates of sentinel lymph nodes were 86.5% and 55.9%, respectively. The highest detection rate was achieved in the subgroup with a combined use of Indocyanine green (ICG) and Carbon nanoparticles (CNP) (94.9% for unilateral detection and 66.7% for bilateral detection). The upper paracervical pathway (UPP) was detected in 93.3% of cases in the high-risk group and 96.0% of cases in the low-risk group (p = 0.261). The lower paracervical pathway (LPP) was detected in 10.0% of cases in the high-risk group and 17.9% of cases in the low-risk group (p = 0.048). Remarkably increased detection rates of SLN in the common iliac (7.5%) and para-aortic or precaval areas (2.9%) were observed in the high-risk group. In contrast, a markedly decreased detection rate of SLN in the internal iliac area (1.9%) was observed in the high-risk group. Conclusion The combined use of ICG and CNP improved the bilateral detection rate of SLN in the high-risk group. The detection of UPP is important for both high-risk and low-risk cases, while LPP detection plays a more important role in the low-risk group. Lymphadenectomy in the common iliac and para-aortic or precaval areas is essential for patients with high-risk EC. Removal of internal iliac lymph nodes is essential for patients with low-risk EC, in case of ineffective SLN mapping.

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Impact of severe obesity in the management of patients with high-risk endometrial cancer: A FRANCOGYN study

Cited by 3 publications

References 36 publications

The Effectiveness of Metabolic Bariatric Surgery in Preventing Gynecologic Cancer - from Pathophysiology to Clinical Outcomes

The Effectiveness of Metabolic Bariatric Surgery in Preventing Gynecologic Cancer - from Pathophysiology to Clinical Outcomes

Comparison of sentinel lymph node distribution and lymphatic drainage pathway between high- and low-risk endometrial cancers

Comparison of sentinel lymph node distribution and lymphatic drainage pathway between high- and low-risk endometrial cancers

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