The Impact of Body Mass Index on Robotic Surgery Outcomes in Endometrial Cancer

STRUCTURED ABSTRACT OBJECTIVES To compare surgical outcomes of patients with endometrial cancer who underwent robotic surgery across different BMI categories. METHODS A retrospective study including all consecutive patients with endometrial cancer who underwent robotic surgery at a tertiary cancer center between December 2007 and December 2022. The study analyzed outcome measures, including blood loss, surgical times, length of hospitalization, perioperative complications, and conversion rates with the Kruskal-Wallis test for BMI group differences and the Chi-squared test for associations between categorical variables. RESULTS A total of 1,329 patients with endometrial cancer were included in the study. Patients were stratified by BMI: <30.0 (n=576; 43.3%), 30.0-39.9 (n=449; 33.8%), and ≥40.0 (n=304; 22.9%). There were no significant differences in post-anesthesia care unit (PACU) stay (p=0.105) and hospital stay (p=0.497) between the groups. The rate of post-op complications was similar across the groups, ranging from 8.0% to 9.5% (p=0.761). The rate of conversion to laparotomy was also similar across the groups, ranging from 0.7% to 1.0% (p=0.885). Women with a BMI ≥40.0 had a non-clinically relevant but greater median estimated blood loss (30 mL vs. 20 mL; p<0.001) and longer median operating room (OR) time (288 minutes vs. 270 minutes; p<0.001). Within the OR time, the median set-up time was longer for those with a higher BMI (58 minutes vs. 50 minutes; p<0.001). However, skin-to-skin time (209 minutes vs. 203 minutes; p=0.202) and post-op time (14 minutes vs. 13 minutes; p=0.094) were comparable between groups. CONCLUSION BMI does not affect the peri-operative outcome of patients undergoing robotic staging procedures for endometrial cancer.