一项评估重度肥胖子宫内膜癌患者术前极低热量饮食的安全性和可行性的单组先导观察研究

IF 1.9 Q4 ONCOLOGY

Cancer reports Pub Date : 2025-04-03 DOI:10.1002/cnr2.70172

Chloe Ayres, Hanna Burbidge, Jayna Garratt, Ganendra Raj Mohan, Yee Leung, Stephanie Jeffares, Sanela Bilic, Paul A. Cohen

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引用次数: 0

摘要

背景术前极低热量饮食（VLCD）可实现快速、安全的减肥，但目前还没有研究对严重肥胖的子宫内膜癌患者进行术前极低热量饮食的评估。我们的目的是评估临床 1 期、1 级子宫内膜腺癌且体重指数≥ 35 kg/m2 的患者在手术前使用 Optifast VLCD 进行为期 4-6 周的术前营养干预的安全性和可行性。方法这是一项由研究者发起的单臂前瞻性观察研究。共同主要终点是安全性和可行性。次要终点是人体测量指标、血压、生化指标、围手术期并发症、住院时间和最终肿瘤分期的变化。VLCD的耐受性和依从性通过每两周一次的问卷调查和尿酮进行评估。结果 28 名患者入选，其中 25 人接受了干预。22/25 名患者（88%）完成了至少 4 周的 Optifast 治疗。平均（标清）年龄为 56.4 (6.3) 岁，平均体重指数 (BMI) 为 45.2 (7.1) kg/m2。体重（平均 8.2 千克 [3.6]）、体重指数（平均 3.1 千克/平方米 [1.3]）、腰围和臀围（分别为平均 5.7 [6.5] 厘米和 4.5 厘米 [4.1]）以及舒张压（10 毫米汞柱 [14.1]）均有显著下降（P 均为 0.001）。一名患者痛风复发。所有患者均接受了腹腔镜手术，未出现不良反应。Optifast 被认为是可以接受的，依从性为 40% 到 61.9%。88%（22/25）的患者最终分期为 FIGO 2009 1A 期 1 级子宫内膜样腺癌。结论对严重肥胖的临床低风险子宫内膜癌患者进行为期 4-6 周的术前 VLCD 似乎安全、可行且耐受性良好。

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A Single Arm Pilot Observational Study to Evaluate the Safety and Feasibility of a Pre-Operative Very Low Calorie Diet in Severely Obese Patients With Endometrial Cancer

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A Single Arm Pilot Observational Study to Evaluate the Safety and Feasibility of a Pre-Operative Very Low Calorie Diet in Severely Obese Patients With Endometrial Cancer

Background

Pre-operative very low calorie diets (VLCDs) can achieve rapid and safe weight loss, yet no studies have evaluated VLCDs in the severely obese endometrial cancer population prior to surgery. Our aim was to evaluate the safety and feasibility of a 4–6 week pre-operative nutritional intervention with the Optifast VLCD prior to surgery in patients with clinical stage 1, Grade 1 endometrioid endometrial adenocarcinoma and a body mass index ≥ 35 kg/m².

Methods

This was an investigator-initiated single-arm prospective observational study. Co-primary endpoints were safety and feasibility. Secondary endpoints were changes in anthropometric measures, blood pressure, biochemistry, perioperative complications, length of stay and final tumour stage. Tolerability and compliance of the VLCD were assessed by fortnightly questionnaires and urinary ketones.

Results

Twenty-eight patients were enrolled, of which 25 underwent the intervention. 22/25 patients (88%) completed at least 4 weeks of Optifast. Mean (SD) age was 56.4 (6.3) years, and mean body mass index (BMI) was 45.2 (7.1) kg/m². Significant decreases in weight (mean 8.2 kg [3.6]), BMI (mean 3.1 kg/m² [1.3]), waist and hip circumference (mean 5.7 [6.5] and 4.5 cm [4.1], respectively), and diastolic blood pressure (10 mmHg [14.1]) were observed (p < 0.001 for all). One patient had a flare of gout. All patients had laparoscopic surgery without adverse events. Optifast was considered acceptable, and compliance was 40% to 61.9%. Eighty-eight percent (22/25) of patients had FIGO 2009 Stage 1A Grade 1 endometrioid endometrial adenocarcinoma on final staging.