EP373/#1103 Concurrent laparoscopic hysterectomy and bariatric surgery for early-stage endometrial cancer and endometrial intraepithelial neoplasia: early results from a prospective feasibility trial. (4th December 2022)

• Record Type: Journal Article
• Authors: Bercow, Alexandra; Fiascone, Stephen; Elias, Kevin; Worley, Michael; Feltmate, Colleen
• Is Part Of: International journal of gynecological cancer. Volume 32(2022)Supplement 3
• Page Start: A205
• Page End: A205
• Publication Date: 2022-12-04
• Subjects: Generative organs, Female -- Cancer -- Periodicals; 616.99465
• DOI: 10.1136/ijgc-2022-igcs.462
• Languages: English
• ISSNs: 1048-891X

Abstract

Abstract : Objectives: The objective of this prospective study is to examine the feasibility of expedited referral to a bariatric surgeon and concurrent laparoscopic hysterectomy and bariatric surgery in obese women with presumed early-stage grade 1 endometrial carcinoma (EC) or endometrial intraepithelial neoplasia (EIN). Methods: Patients are recruited from the Brigham and Women's Hospital gynecologic oncology clinic. Women with EIN or grade 1 EC and BMI≥40 or BMI≥35 with one or more obesity-related comorbidities are eligible. Patients are then referred to a bariatric surgeon with a goal of undergoing concurrent laparoscopic hysterectomy and bariatric surgery within 8 weeks for women with grade 1 EC, 12 weeks for EIN, and 6 months for EIN with IUD in situ. Results: Ten patients were screened and four enrolled. The average age of enrolled patients was 54.5 years old, and BMI was 44.11. Obesity-related comorbidities included hypertension, insulin-dependent diabetes, and obstructive sleep apnea. Average time between initial visit with a gynecologic oncologist and bariatric surgeon was 6.25 days. All women had EIN pathology. Patient #1 was unable to undergo either procedure because of an incidental gastric neuroendocrine tumor and failed cardiac stress test. Patient #2 declined bariatric surgery for personal reasons. Patient #3 was denied coverage by insurance for both procedures. Patient #4 has been approved by insurance and will undergo her concurrent surgeries. Conclusions: Early results demonstrate feasibility of an expedited referral process to a bariatric surgeon for obese women with EIN or grade 1 EC. The outcome of concurrent surgery remains to be seen.