Article Menu

Export Article

More by Authors Links

Article Data

  • Views 848
  • Dowloads 136

Case Reports

Open Access

Combined panniculectomy and surgical staging of endometrial cancer: the Northern Ireland experience

  • James P Beirne1,2,†
  • Susan Addley3,†
  • Gillian V Blayney4
  • Sandra McAllister5
  • Heather Agnew6
  • Elaine F Craig6
  • Ian JG Harley2,6
  • Hans Nagar6
  • Stephen P Dobbs6
  • David Glenn7
  • Patrick Comiskey8
  • Michael Stafford9
  • W Glenn McCluggage10
  • Stephen Sinclair5
  • Mark H McComiskey6,*,

1Department of Gynaecological Oncology, Trinity St. James Cancer Institute, St. James’ Hospital, D08 NHY1 Dublin, Ireland

2Patrick G Johnston Centre for Cancer Research, Queen’s University, BT9 7AE Belfast, Northern Ireland

3Royal Derby Hospital, University Hospitals of Derby and Burton NHS Trust, DE22 3NE Derby, UK

4Royal Jubilee Maternity Service, Royal Group of Hospitals, Belfast Health and Social Care Trust, BT12 6BA Belfast, Northern Ireland

5Department of Plastic Surgery, Ulster Hospital, South-Eastern Health and Social Care Trust, BT16 1RH Dundonald, Northern Ireland

6Northern Ireland Gynaecological Cancer Centre, Belfast City Hospital, Belfast Health and Social Care Trust, BT9 7AB Belfast, Northern Ireland

7Department of Obstetrics and Gynaecology, Ulster Hospital, South-Eastern Health and Social Care Trust, BT16 1RH Dundonald, Northern Ireland

8Department of Medical Photography, Ulster Hospital, South-Eastern Health and Social Care Trust, BT16 1RH Dundonald, Northern Ireland

9Department of Anaesthetics, Ulster Hospital, South-Eastern Health and Social Care Trust, BT16 1RH Dundonald, Northern Ireland

10Department of Pathology, Royal Group of Hospitals, Belfast Health and Social Care Trust, BT12 6BA Belfast, Northern Ireland

DOI: 10.31083/j.ejgo4301001 Vol.43,Issue 1,February 2022 pp.146-152

Submitted: 06 July 2021 Accepted: 11 October 2021

Published: 15 February 2022

*Corresponding Author(s): Mark H McComiskey E-mail: mark.mccomiskey@belfasttrust.hscni.net

† These authors contributed equally.

PDF (4.21 MB)

Abstract

Background: Endometrial cancer is the most common gynaecological malignancy in the Western world and has a strong association with obesity. The incidence of endometrial cancer is rising and can be attributed, in part, to the ongoing obesity epidemic. The surgical management of endometrial cancer in women with class III obesity, defined as those with a body mass index (BMI) ≥40 kg/m2, can be particularly challenging. Case(s): We report the early experience of panniculectomy as an adjunct to endometrial cancer staging surgery in Northern Ireland (NI). We outline the generic surgical approach and report the outcomes of the first four cases undertaken. We discuss the important role that panniculectomy holds in the surgical management of endometrial cancer in women with III obesity. Conclusion: The initial experience, in NI, of panniculectomy as an adjunct to endometrial cancer staging surgery greatly facilitated surgical exposure and allowed adequate surgical staging to be performed. In carefully selected cases, the surgical procedure can be completed safely and effectively with greater ease.


Keywords

Obesity; Endometrial cancer; Panniculectomy; Apronectomy

Cite and Share

James P Beirne,Susan Addley,Gillian V Blayney,Sandra McAllister,Heather Agnew,Elaine F Craig,Ian JG Harley,Hans Nagar,Stephen P Dobbs,David Glenn,Patrick Comiskey,Michael Stafford,W Glenn McCluggage,Stephen Sinclair, Mark H McComiskey. Combined panniculectomy and surgical staging of endometrial cancer: the Northern Ireland experience. European Journal of Gynaecological Oncology. 2022. 43(1);146-152.

URL:

https://www.ejgo.net/articles/10.31083/j.ejgo4301001

References

[1] Registry National Informatics Centre. Uterus Body Cancer. Queen’s University: Belfast. 2017.

[2] Mullins MA, Cote ML. Beyond Obesity: the Rising Incidence and Mortality Rates of Uterine Corpus Cancer. Journal of Clinical Oncology. 2019; 37: 1851–1853.

[3] Renehan AG, Tyson M, Egger M, Heller RF, Zwahlen M. Body-mass index and incidence of cancer: a systematic review and meta-analysis of prospective observational studies. Lancet. 2008; 371: 569–578.

[4] Linkov F, Kokai L, Edwards R, Sheikh MA, Freese KE, Marra KG, et al. The role of adipose-derived stem cells in endometrial cancer proliferation. Scandinavian Journal of Clinical and Laboratory Investigation. Supplementum. 2014; 244: 54–58.

[5] Musingarimi P. Obesity in the UK: a review and comparative analysis of policies within the devolved administrations. Health Policy. 2009; 91: 10–16.

[6] Fader AN, Arriba LN, Frasure HE, von Gruenigen VE. Endometrial cancer and obesity: epidemiology, biomarkers, prevention and survivorship. Gynecologic Oncology. 2009; 114: 121–127.

[7] Mahdi H, Jernigan AM, Aljebori Q, Lockhart D, Moslemi-Kebria M. The impact of obesity on the 30-day morbidity and mortality after surgery for endometrial cancer. Journal of Minimally Invasive Gynecology. 2015; 22: 94–102.

[8] Janda M, Gebski V, Davies LC, Forder P, Brand A, Hogg R, et al. Effect of Total Laparoscopic Hysterectomy vs Total Abdominal Hysterectomy on Disease-Free Survival among Women with Stage i Endometrial Cancer: a Randomized Clinical Trial. Journal of the American Medical Association. 2017; 317: 1224–1233.

[9] Mourits MJE, Bijen CB, Arts HJ, ter Brugge HG, van der Sijde R, Paulsen L, et al. Safety of laparoscopy versus laparotomy in early-stage endometrial cancer: a randomised trial. The Lancet Oncology. 2010; 11: 763–771.

[10] Walker JL, Piedmonte MR, Spirtos NM, Eisenkop SM, Schlaerth JB, Mannel RS, et al. Laparoscopy compared with laparotomy for comprehensive surgical staging of uterine cancer: Gynecologic Oncology Group Study LAP2. Journal of Clinical Oncology. 2009; 27: 5331–5336.

[11] Zhao Y, Liu Z, Yu L, Liu S, Yan H, Zhang Y, et al. Robotic surgery in obese patients with early-stage endometrial cancer. Videosurgery and other Miniinvasive Techniques. 2020; 15: 171–175.

[12] Kitson SJ, Crosbie EJ. Endometrial cancer and obesity. The Obstetrician & Gynaecologist. 2019; 21: 237–245.

[13] Winfield RD, Reese S, Bochicchio K, Mazuski JE, Bochicchio GV. Obesity and the Risk for Surgical Site Infection in Abdominal Surgery. The American Surgeon. 2016; 82: 331–336.

[14] Crosbie EJ, Estabragh ZR, Murphy J, Ahmed AS, Slade RJ. Apronectomy combined with laparotomy for morbidly obese endometrial cancer patients. Surgical Oncology. 2011; 20: e187–e193.

[15] Tillmanns TD, Kamelle SA, Abudayyeh I, McMeekin SD, Gold MA, Korkos TG, et al. Panniculectomy with simultaneous gynecologic oncology surgery. Gynecologic Oncology. 2001; 83: 518–522.

[16] Hopkins MP, Shriner AM, Parker MG, Scott L. Panniculectomy at the time of gynecologic surgery in morbidly obese patients. American Journal of Obstetrics and Gynecology. 2000; 182: 1502–1505.

[17] Barr CE, Ryan NA, Derbyshire AE, Wan YL, MacKintosh ML, McVey RJ, et al. Weight loss during intrauterine progestin treatment for obesity-associated atypical hyperplasia and early stage cancer of the endometrium. Cancer Prevention Research. 2021.(in press)

Abstracted / indexed in

Science Citation Index Expanded (SciSearch) Created as SCI in 1964, Science Citation Index Expanded now indexes over 9,500 of the world’s most impactful journals across 178 scientific disciplines. More than 53 million records and 1.18 billion cited references date back from 1900 to present.

Biological Abstracts Easily discover critical journal coverage of the life sciences with Biological Abstracts, produced by the Web of Science Group, with topics ranging from botany to microbiology to pharmacology. Including BIOSIS indexing and MeSH terms, specialized indexing in Biological Abstracts helps you to discover more accurate, context-sensitive results.

Google Scholar Google Scholar is a freely accessible web search engine that indexes the full text or metadata of scholarly literature across an array of publishing formats and disciplines.

JournalSeek Genamics JournalSeek is the largest completely categorized database of freely available journal information available on the internet. The database presently contains 39226 titles. Journal information includes the description (aims and scope), journal abbreviation, journal homepage link, subject category and ISSN.

Current Contents - Clinical Medicine Current Contents - Clinical Medicine provides easy access to complete tables of contents, abstracts, bibliographic information and all other significant items in recently published issues from over 1,000 leading journals in clinical medicine.

BIOSIS Previews BIOSIS Previews is an English-language, bibliographic database service, with abstracts and citation indexing. It is part of Clarivate Analytics Web of Science suite. BIOSIS Previews indexes data from 1926 to the present.

Journal Citation Reports/Science Edition Journal Citation Reports/Science Edition aims to evaluate a journal’s value from multiple perspectives including the journal impact factor, descriptive data about a journal’s open access content as well as contributing authors, and provide readers a transparent and publisher-neutral data & statistics information about the journal.

Submission Turnaround Time

Conferences

Top