Endometrial<\/a> cancer is the most common gynaecological cancer in high-income countries and is more strongly linked to obesity than almost any other cancer. Excess weight also raises the risk of complications after the surgery used to treat it.<\/p>\nResearchers from nine hospitals across England recruited 78 women with a BMI of 28 kg\/m\u00b2 or higher who were awaiting curative surgery for endometrial cancer and randomly assigned them to receive either routine care or a dietetic-supported programme.<\/p>\n
The programme involved replacing normal food entirely with nutritionally complete meal replacement products, providing around 800 kcal and 76g of protein a day, alongside regular telephone support from a dietitian.<\/p>\n
Because surgery for endometrial cancer typically cannot be delayed for long, participants followed the programme for a median of just 28 days before their operation, a notably tighter window than similar preoperative weight loss studies in other cancers.<\/p>\n
Fewer Complications After Surgery<\/p>\n
Despite the short timeframe, women in the intervention group lost an average of 5.3kg before surgery, 3.5kg more than those receiving routine care. Almost half (44%) achieved a clinically meaningful weight loss of 5% or more, compared with just 12% in the routine care group.<\/p>\n
Researchers found that just 27% of women in the intervention group experienced a postoperative complication within 30 days, compared with 51% of those receiving routine care.<\/p>\n
This difference was driven mainly by fewer moderate (grade II) complications, the kind typically requiring medical intervention such as antibiotics or blood transfusion.<\/p>\n
No serious adverse events were linked to the diet itself, and quality of life, anxiety, and depression scores were similar between the two groups throughout.<\/p>\n
Setting the Stage for a Larger Trial<\/p>\n
Crucially, researchers found no evidence that this rapid weight loss came at the expense of fat-free mass. Muscle and other lean tissue were largely preserved, addressing common concerns with very low-calorie diets, particularly in older or surgical populations where muscle loss can worsen recovery.<\/p>\n
Levels of engagement with the programme was high, with 85% of participants attending their scheduled dietitian calls, and most who tried the diet rated it positively<\/p>\n
As a feasibility study, it suggests that a full-scale trial could conclude more definitively whether pre-surgery weight loss programmes could lead to better outcomes for women with endometrial cancer.<\/p>\n
The one area falling short was the proportion of participants reaching 5% weight loss, which landed just below the original goal. For this reason, researchers suggest that any future research could benefit from adaptations to enhance weight loss by participants.<\/p>\n
Overall, authors suggest that involving women earlier in their diagnostic pathway, therefore allowing more time on the programme, could help more participants reach that threshold in future research.<\/p>\n
Reference<\/p>\n
Koutoukidis D et al. Intentional weight loss before endometrial cancer surgery to support postoperative recovery (ENDO-CARE): a multicentre, feasibility randomised controlled trial in England. The Lancet Obstetrics, Gynaecology, & Women\u2019s Health, 2026<\/p>\n
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