OBJECTIVE:More patient-centered programming is essential for endometrial cancer (EC) survivors needing to lose weight to reduce cardiovascular disease risk (CVD). The purpose of this study was to improve self-efficacy (SE) and quality of life (QOL) using a lifestyle intervention program designed for weight loss. METHODS:Overweight and obese early-stage EC survivors, n = 75, were randomized into two groups: 1) Survivors of Uterine Cancer Empowered by Exercise and Healthy Diet (SUCCEED), a six-month lifestyle intervention or 2) a usual care group (UC). Participants completed the Weight Efficacy Lifestyle Questionnaire (WEL) to assess SE and the Functional Assessment of Cancer Therapy-General (FACT-G) to measure QOL, and their body mass index (BMI) was calculated at baseline, 3, 6, and 12 months. Mixed, repeated-measures ANCOVA models with baseline covariates were employed using SPSS 20.0. RESULTS:Positive effects in every WEL domain, including the total score, were statistically significant in the SUCCEED group versus the UC group. A linear regression model demonstrated that, if BMI decreased by 1 unit, the total WEL score increased by 4.49 points. Significant negative correlations were found in the total WEL score and a change in BMI of R = -0.356 (p = 0.006). Between-group differences in the FACT-G were significant from baseline in the fatigue domain at three months (p = .008) and in the physical domain at six months (p = .048). No other significant differences were found. CONCLUSION:Overall, this study shows promise for targeted interventions to help improve SE, thus improving BMI.

5075 Background: To explore the association between baseline quality-of-life (QOL) domain scores and overall survival (OS) in ovarian cancer patients receiving adjuvant chemotherapy. Methods: Patients with optimal stage III ovarian cancer on Gynecologic Oncology Group protocol #172 completed the Functional Assessment of Cancer Therapy-Generic (FACT-G) and were then randomly assigned to either intravenous (IV) or intraperitoneal (IP) chemotherapy. The FACT scale includes physical, functional, social, and emotional well- being domains (PWB, FWB, SWB, EWB). Patients who rated their lack of energy as ‘

Study Objective: Studies have demonstrated that laparoscopic staging in endometrial cancer (EC) patients is safe and feasible, with comparable surgical/oncologic outcomes to laparotomy. These reports have focused on patients with Type I malignancies. The study objective was to compare the surgical and oncologic outcomes of the higher risk Type II EC patients who were staged by laparoscopy/robotics versus laparotomy. Design: Retrospective cohort study. Setting: Multi-institution, academic tertiary care centers. Patients: Patients with uterine serous, clear cell or grade 3 endometrioid adenocarcinoma. Intervention: Surgical staging via minimally invasive (MIS) or open approaches. Staging included hysterectomy/BSO/pelvic and para-aortic lymphadenectomy (LN) +/- omentectomy. Measurements and Main Results: 193 patients met criteria: 81 staged by laparotomy and 112 by MIS. Subgroups were well matched by age, BMI, history of previous abdominal surgery, histology and adjuvant therapies. 71% of MIS pts had early-stage (Stage I/II) disease versus 58% of laparotomy pts (p=.001). Median OR times for the MIS versus laparotomy cohorts were 203 and 133 min, respectively (p<.001). Median number of LNs were higher in the MIS cohort (p<.001; total 23 vs.15). Further, MIS patients experienced fewer complications when compared to the laparotomy cohort (8% vs. 35.8%;p<.001). After adjusting for stage, risk of recurrence was similar between groups (median follow-up: 23 mos; p=0.35). PFS and OS was 81.1 and 95.2 months for MIS patients and 83 and 106.8 months in laparotomy pts (p=.31 and .52, respectively). On multivariate analysis, stage, but not surgical approach, was associated with PFS and OS (p<.001). Conclusion: Type II EC patients staged by MIS techniques experienced fewer complications and similar survival outcomes when compared to those staged by laparotomy. As this patient cohort is older and most will receive adjuvant therapies, minimization of surgical morbidity and recovery times is of interest. High-risk histologic subtype should not be considered a contraindication to MIS in women with apparent early-stage disease.

Study ObjectiveTo compare surgical and survival outcomes of patients with early-stage endometrial cancer (EC) who underwent total laparoscopic hysterectomy (TLH) or laparoscopic-assisted vaginal hysterectomy (LAVH) ± lymphadenectomy.DesignRetrospective, nonrandomized clinical study (Canadian Task Force classification II-2).SettingTwo tertiary care academic medical centers.PatientsPatients with EC treated by TLH or LAVH from 1998 through 2006.InterventionsTLH and LAVH were performed in 80 and 24 patients, respectively. Patient demographics and clinical variables were collected, and surgical and survival outcomes were determined.Measurements and Main ResultsMedian operating time was significantly higher for patients undergoing LAVH than for those undergoing TLH (212.5 and 183.5 minutes, respectively; p = .039). EBL was also greater in patients undergoing LAVH (median 220 mL) compared with those undergoing TLH (median100 mL; p = .001). After a median follow-up time of 51.5 months, there was no difference in recurrence or survival rates between the groups.ConclusionEarly-stage EC can be treated effectively with either TLH or LAVH. TLH patients may experience shorter operating times and less blood loss. When performed by experienced laparoscopists, TLH may be more feasible than LAVH in this cohort of patients.

Endometrial cancer is the most common gynecologic cancer and is strongly associated with obesity. Most women with endometrial cancer survive with standard treatment, but death rates remain elevated due to obesity-related co-morbidities. The purpose of this study was to determine the effects of nutrition and exercise counseling on nutrient intake and body weight in obese endometrial cancer survivors.