Role of Bariatric Surgery in Patients With Endometrial Cancer: A Case Report and Review of Literature
-
Maliheh Arab
,
Azadeh Jafari Ashtiani
,
Behnaz Ghavami
,
Behnaz Nouri
,
Giti Noghabaei
,
Masoomeh Rauofi
Abstract
Objective: The standard surgery for endometrial cancer can be deferred in some situations, including morbid obesity, comorbidities, and the patient's desire for fertility. One of the options to improve patients' circumstances is bariatric surgery.
Case report: This study presented two patients with stage IA, grade I endometrioid endometrial adenocarcinoma. Both patients had morbid obesity and had comorbidities. In case 1, because of fertility preservation, and in case 2, because of severe comorbidities, hormone therapy was started, followed by bariatric surgery after counseling patients. Both patients had acceptable changes in body mass index during follow-up, so cancer surgery through laparoscopy was done. Both patients did not need adjuvant therapy; months after cancer surgery, there is no recurrence, and their body mass index is also decreasing.
Conclusion: Bariatric surgery can improve outcomes in patients with morbid obesity who suffer endometrial cancer.
1. Trojano G, Olivieri C, Tinelli R, Damiani GR, Pellegrino A, Cicinelli E. Conservative treatment in early stage endometrial cancer: a review. Acta Biomed. 2019 Dec 23;90(4):405-410.
2. Moore K, Brewer MA. Endometrial Cancer: Is This a New Disease? Am Soc Clin Oncol Educ Book. 2017;37:435-442.
3. Papatla K, Huang M, Slomovitz B. The obese endometrial cancer patient: how do we effectively improve morbidity and mortality in this patient population? Ann Oncol. 2016 Nov;27(11):1988-1994.
4. Onstad MA, Schmandt RE, Lu KH. Addressing the role of obesity in endometrial cancer risk, prevention, and treatment. Journal of Clinical Oncology. 2016; 34(35):4225.
5. Mihm M, Gangooly S, Muttukrishna S. The normal menstrual cycle in women. Anim Reprod Sci. 2011 Apr;124(3-4):229-36.
6. Davis SR, Lambrinoudaki I, Lumsden M, Mishra G D, Pal L, Rees M, et al. Menopause. Reproductive Endocrinology. 2015; 22:77-84.
7. Blakemore J, Naftolin F. Aromatase: Contributions to Physiology and Disease in Women and Men. Physiology (Bethesda). 2016;31(4):258-69.
8. O'Connor KA, Ferrell RJ, Brindle E, Shofer J, Holman DJ, Miller RC, et al. Total and unopposed estrogen exposure across stages of the transition to menopause. Cancer Epidemiol Biomarkers Prev. 2009;18(3):828-36.
9. Corzo C, Barrientos Santillan N, Westin SN, Ramirez PT. Updates on Conservative Management of Endometrial Cancer. J Minim Invasive Gynecol. 2018 Feb;25(2):308-313.
10. Bruno DS, Berger NA. Impact of bariatric surgery on cancer risk reduction. Ann Transl Med. 2020 Mar;8(Suppl 1):S13.
11. Mackenzie H, Markar SR, Askari A, Faiz O, Hull M, Purkayastha S, et al. Obesity surgery and risk of cancer. Br J Surg. 2018 Nov;105(12):1650-1657.
12. von Gruenigen VE, Tian C, Frasure H, Waggoner S, Keys H, Barakat RR. Treatment effects, disease recurrence, and survival in obese women with early endometrial carcinoma: a Gynecologic Oncology Group study. Cancer. 2006;107(12):2786-91.
13. Papatla K, Huang M, Slomovitz B. The obese endometrial cancer patient: how do we effectively improve morbidity and mortality in this patient population? Ann Oncol. 2016;27(11):1988-1994.
14. Neff R, Havrilesky LJ, Chino J, O'Malley DM, Cohn DE. Bariatric surgery as a means to decrease mortality in women with type I endometrial cancer - An intriguing option in a population at risk for dying of complications of metabolic syndrome. Gynecol Oncol. 2015;138(3):597-602.
15. Fiascone S, Danilack VA, Kao MJ, Cohen M, Singh K, Kalife E, et al. While women await surgery for type I endometrial cancer, depot medroxyprogesterone acetate reduces tumor glandular cellularity. Am J Obstet Gynecol. 2018;219(4):381.e1-381.e10.
16. Pal N, Broaddus RR, Urbauer DL, Balakrishnan N, Milbourne A, Schmeler KM, et al. Treatment of Low-Risk Endometrial Cancer and Complex Atypical Hyperplasia With the Levonorgestrel-Releasing Intrauterine Device.
Obstet Gynecol. 2018;131(1):109-116.
17. Jernigan AM, Maurer KA, Cooper K, Schauer PR, Rose PG, Michener CM. Referring survivors of endometrial cancer and complex atypical hyperplasia to bariatric specialists: a prospective cohort study. Am
J Obstet Gynecol. 2015;213(3):350.e1-10.
18. Orekoya O, Samson ME, Trivedi T, Vyas S, Steck SE. The Impact of Obesity on Surgical Outcome in Endometrial Cancer Patients: A Systematic Review.
J Gynecol Surg. 2016;32(3):149-157.
19. Obermair A, Brennan DJ, Baxter E, Armes JE, Gebski V, Janda M. Surgical safety and personal costs in morbidly obese, multimorbid patients diagnosed with early-stage endometrial cancer having a hysterectomy. Gynecol Oncol Res Pract. 2016;3:1.
20. Upala S, Sanguankeo A. Bariatric Surgery Improves Outcome in Obese Women With Endometrial Cancer.
J Minim Invasive Gynecol. 2016;23(1):138-9.
21. Lee E, Kawaguchi ES, Zhang J, Kim SE, Deapen D, Liu L, et al. Bariatric surgery in patients with breast and endometrial cancer in California: population-based prevalence and survival. Surg Obes Relat Dis. 2022;18(1):42-52.
22. Shafa A, Kumar A, Torres D, McKenzie TJ. Minimally Invasive Hysterectomy and Bariatric Surgery to Improve Endometrial Cancer Survivorship. Obstet Gynecol. 2019;134(3):570-572.
23. Kitson S, Ryan N, MacKintosh ML, Edmondson R, Duffy JM, Crosbie EJ. Interventions for weight reduction in obesity to improve survival in women with endometrial cancer. Cochrane Database Syst Rev. 2018;2(2):CD012513.
24. Montemorano L, Smrz SA, Jalilvand AD, Noria SF, Salani R. Bariatric surgery after failed conservative management in a morbidly obese patient with endometrial cancer. Gynecol Oncol Rep. 2019;27:69-71.
25. Sharma N, Ragupathy K. Morbidly obese patient with endometrial cancer treated by bariatric surgery to enable cancer treatment. BMJ Case Rep. 2021;14(7):e243843.
2. Moore K, Brewer MA. Endometrial Cancer: Is This a New Disease? Am Soc Clin Oncol Educ Book. 2017;37:435-442.
3. Papatla K, Huang M, Slomovitz B. The obese endometrial cancer patient: how do we effectively improve morbidity and mortality in this patient population? Ann Oncol. 2016 Nov;27(11):1988-1994.
4. Onstad MA, Schmandt RE, Lu KH. Addressing the role of obesity in endometrial cancer risk, prevention, and treatment. Journal of Clinical Oncology. 2016; 34(35):4225.
5. Mihm M, Gangooly S, Muttukrishna S. The normal menstrual cycle in women. Anim Reprod Sci. 2011 Apr;124(3-4):229-36.
6. Davis SR, Lambrinoudaki I, Lumsden M, Mishra G D, Pal L, Rees M, et al. Menopause. Reproductive Endocrinology. 2015; 22:77-84.
7. Blakemore J, Naftolin F. Aromatase: Contributions to Physiology and Disease in Women and Men. Physiology (Bethesda). 2016;31(4):258-69.
8. O'Connor KA, Ferrell RJ, Brindle E, Shofer J, Holman DJ, Miller RC, et al. Total and unopposed estrogen exposure across stages of the transition to menopause. Cancer Epidemiol Biomarkers Prev. 2009;18(3):828-36.
9. Corzo C, Barrientos Santillan N, Westin SN, Ramirez PT. Updates on Conservative Management of Endometrial Cancer. J Minim Invasive Gynecol. 2018 Feb;25(2):308-313.
10. Bruno DS, Berger NA. Impact of bariatric surgery on cancer risk reduction. Ann Transl Med. 2020 Mar;8(Suppl 1):S13.
11. Mackenzie H, Markar SR, Askari A, Faiz O, Hull M, Purkayastha S, et al. Obesity surgery and risk of cancer. Br J Surg. 2018 Nov;105(12):1650-1657.
12. von Gruenigen VE, Tian C, Frasure H, Waggoner S, Keys H, Barakat RR. Treatment effects, disease recurrence, and survival in obese women with early endometrial carcinoma: a Gynecologic Oncology Group study. Cancer. 2006;107(12):2786-91.
13. Papatla K, Huang M, Slomovitz B. The obese endometrial cancer patient: how do we effectively improve morbidity and mortality in this patient population? Ann Oncol. 2016;27(11):1988-1994.
14. Neff R, Havrilesky LJ, Chino J, O'Malley DM, Cohn DE. Bariatric surgery as a means to decrease mortality in women with type I endometrial cancer - An intriguing option in a population at risk for dying of complications of metabolic syndrome. Gynecol Oncol. 2015;138(3):597-602.
15. Fiascone S, Danilack VA, Kao MJ, Cohen M, Singh K, Kalife E, et al. While women await surgery for type I endometrial cancer, depot medroxyprogesterone acetate reduces tumor glandular cellularity. Am J Obstet Gynecol. 2018;219(4):381.e1-381.e10.
16. Pal N, Broaddus RR, Urbauer DL, Balakrishnan N, Milbourne A, Schmeler KM, et al. Treatment of Low-Risk Endometrial Cancer and Complex Atypical Hyperplasia With the Levonorgestrel-Releasing Intrauterine Device.
Obstet Gynecol. 2018;131(1):109-116.
17. Jernigan AM, Maurer KA, Cooper K, Schauer PR, Rose PG, Michener CM. Referring survivors of endometrial cancer and complex atypical hyperplasia to bariatric specialists: a prospective cohort study. Am
J Obstet Gynecol. 2015;213(3):350.e1-10.
18. Orekoya O, Samson ME, Trivedi T, Vyas S, Steck SE. The Impact of Obesity on Surgical Outcome in Endometrial Cancer Patients: A Systematic Review.
J Gynecol Surg. 2016;32(3):149-157.
19. Obermair A, Brennan DJ, Baxter E, Armes JE, Gebski V, Janda M. Surgical safety and personal costs in morbidly obese, multimorbid patients diagnosed with early-stage endometrial cancer having a hysterectomy. Gynecol Oncol Res Pract. 2016;3:1.
20. Upala S, Sanguankeo A. Bariatric Surgery Improves Outcome in Obese Women With Endometrial Cancer.
J Minim Invasive Gynecol. 2016;23(1):138-9.
21. Lee E, Kawaguchi ES, Zhang J, Kim SE, Deapen D, Liu L, et al. Bariatric surgery in patients with breast and endometrial cancer in California: population-based prevalence and survival. Surg Obes Relat Dis. 2022;18(1):42-52.
22. Shafa A, Kumar A, Torres D, McKenzie TJ. Minimally Invasive Hysterectomy and Bariatric Surgery to Improve Endometrial Cancer Survivorship. Obstet Gynecol. 2019;134(3):570-572.
23. Kitson S, Ryan N, MacKintosh ML, Edmondson R, Duffy JM, Crosbie EJ. Interventions for weight reduction in obesity to improve survival in women with endometrial cancer. Cochrane Database Syst Rev. 2018;2(2):CD012513.
24. Montemorano L, Smrz SA, Jalilvand AD, Noria SF, Salani R. Bariatric surgery after failed conservative management in a morbidly obese patient with endometrial cancer. Gynecol Oncol Rep. 2019;27:69-71.
25. Sharma N, Ragupathy K. Morbidly obese patient with endometrial cancer treated by bariatric surgery to enable cancer treatment. BMJ Case Rep. 2021;14(7):e243843.
| Files | ||
| Issue | Vol 18, No 2 (June 2024) | |
| Section | Case Reports | |
| DOI | https://doi.org/10.18502/jfrh.v18i2.15938 | |
| Keywords | ||
| Endometrial Neoplasms Morbid Obesity Bariatric Surgery | ||
| Rights and permissions | |
|
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
How to Cite
1.
Arab M, Jafari Ashtiani A, Ghavami B, Nouri B, Noghabaei G, Rauofi M. Role of Bariatric Surgery in Patients With Endometrial Cancer: A Case Report and Review of Literature. J Family Reprod Health. 2024;18(2):140-145.
