Preoperative weight loss may be beneficial in women undergoing endometrial cancer surgery

In women with obesity who are scheduled to undergo endometrial cancer surgery, a preoperative weight loss intervention is feasible, helping reduce weight and the incidence of postoperative complications, according to a study.

The feasibility study was conducted at nine centres across UK and included 72 women (median age 60 years) with a mean BMI of 38.5 kg/m² awaiting curative endometrial cancer surgery. These participants were randomly assigned to undergo routine care (n=35) or dietetic support with a low-energy (800 kcal/day, 76 g protein per day) total diet replacement programme (n=37) between diagnosis and surgery.

The primary outcome was feasibility to progress to a definitive trial, defined on the basis of sufficient levels of recruitment (≥72 participants), engagement (≥75 percent of dietetic telephone appointments attended), adherence (≥60 percent of intervention participants reaching ≥5 percent weight loss), and retention (≥85 percent). Secondary outcomes were complications, symptoms, and changes in weight and fat-free mass.

Participants attended 85 percent of their dietetic appointments, and retention was 86 percent. The median time from randomization to surgery was 28 days, during which 44 percent of participants in the intervention group and 12 percent in the routine care group lost ≥5 percent of their weight (odds ratio [OR], 6, 95 percent confidence interval [CI], 1.75–20.59).

Before surgery, the intervention group lost a mean of 5.3 kg, whereas the routine care group lost a mean of 1.8 kg. There was no between-group difference in fat-free mass.

Postoperative complications were less likely to occur in the intervention group vs the routine care group (27 percent vs 51 percent; OR, 0.35, 95 percent CI, 0.13–0.93). There were no serious adverse events reported.