Combined Surgery for Uterine and Renal Cell Cancers in Obese Patients: A Case Series

Ross Harrison, Laura B. Huffman, E. Jason Abel, Stephen Rose

Abstract


We describe our experience with concomitant surgery for synchronously diagnosed uterine and renal cell cancer, two obesity-linked malignancies, to better identify the challenges posed by such patients. Our institution’s tumor registry and renal cell cancer database were queried for patients with both coincident cancers who were treated from 2000 to present day. The medical records of these patients were systematically reviewed. Six patients were synchronously diagnosed with both uterine and renal cell cancer and underwent combined surgical management. Five of these were performed by an open approach and one by using a minimally invasive surgery (MIS) technique. The majority of patients who had open surgery experienced significant operative or perioperative morbidity. One of these five patients died on postoperative day 3 due to complications from surgery in the setting of significant medical comorbidities. Two other patients with open surgery required splenectomy due to iatrogenic injury at the time of nephrectomy. An MIS technique was utilized for the patient with the largest body mass index (61 kg/m2). This patient recovered without complications. Our experience with combined surgery for coincident uterine and renal cell cancer suggests caution when planning such a procedure. An open approach carries with it significant risk for morbidity, especially in comorbid patients. An MIS approach should be considered when feasible. Synchronous diagnoses of these cancers are rare, but may become more common with the increasing prevalence of obesity.




J Clin Gynecol Obstet. 2016;5(3):92-96
doi: http://dx.doi.org/10.14740/jcgo412w

Keywords


Uterine cancer; Renal cell cancer; Obesity; Surgery; Preoperative outcomes; Combined surgery

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