Higher visceral fat area/subcutaneous fat area ratio measured by computed tomography is associated with recurrence and poor survival in patients with mid and low rectal cancers

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Abstract

Purpose: Obesity is thought to influence postoperative complications and recurrence of mid and low rectal cancer (MLRC) because of intraoperative technical difficulties. However, few reports have described the relationship between obesity indices and the clinical outcomes of MLRC. This study aimed to investigate the association between visceral obesity on computed tomography (CT) and oncolofical outcomes after surgery for MLRC and identify the obesity index that most accurately reflects clinical outcomes. Methods: We investigated 125 patients who underwent curative resection for MLRC between 2004 and 2010. Visceral fat area (VFA) was defined as the umbilicus-level intra-abdominal adipose tissue area measured by CT. Body mass index (BMI), total fat area, VFA, subcutaneous fat area (SFA) and VFA/SFA ratio (V/S ratio) were analysed. Results: The median follow-up time was 60.3 months (range, 38.2–122.6 months). Recurrence was detected in 28 (22.4%) patients. Among the various obesity indices, recurrence was significantly associated with V/S ratio only (1.02 ± 0.45 versus 0.86 ± 0.34; P = 0.046). Stage, preoperative carcinoembryonic antigen level, V/S ratio, lymphatic invasion and perineural invasion were significantly associated with recurrence on univariate analysis, while only V/S ratio (P = 0.019; 95% confidence interval, 1.22 to 9.09) was significantly associated with recurrence on multivariate analysis. Disease-free and overall survival of the obese group (V/S ratio > 1.0) were shorter than those of the non-obese group. Conclusions: V/S ratio is the optimal obesity index for predicting stage I–III MLRC recurrence.

Original languageEnglish
Pages (from-to)1303-1307
Number of pages5
JournalInternational Journal of Colorectal Disease
Volume33
Issue number9
DOIs
StatePublished - 2018 Sep 1

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Intra-Abdominal Fat
Subcutaneous Fat
Rectal Neoplasms
Tomography
Recurrence
Obesity
Survival
Umbilicus
Abdominal Obesity
Carcinoembryonic Antigen
Disease-Free Survival
Body Mass Index
Multivariate Analysis
Fats
Confidence Intervals

Keywords

  • Obesity
  • Rectal cancer
  • Visceral
  • Visceral fat area/subcutaneous fat area ratio

Cite this

@article{8291dd15520f4c639dcac14152ed4460,
title = "Higher visceral fat area/subcutaneous fat area ratio measured by computed tomography is associated with recurrence and poor survival in patients with mid and low rectal cancers",
abstract = "Purpose: Obesity is thought to influence postoperative complications and recurrence of mid and low rectal cancer (MLRC) because of intraoperative technical difficulties. However, few reports have described the relationship between obesity indices and the clinical outcomes of MLRC. This study aimed to investigate the association between visceral obesity on computed tomography (CT) and oncolofical outcomes after surgery for MLRC and identify the obesity index that most accurately reflects clinical outcomes. Methods: We investigated 125 patients who underwent curative resection for MLRC between 2004 and 2010. Visceral fat area (VFA) was defined as the umbilicus-level intra-abdominal adipose tissue area measured by CT. Body mass index (BMI), total fat area, VFA, subcutaneous fat area (SFA) and VFA/SFA ratio (V/S ratio) were analysed. Results: The median follow-up time was 60.3 months (range, 38.2–122.6 months). Recurrence was detected in 28 (22.4{\%}) patients. Among the various obesity indices, recurrence was significantly associated with V/S ratio only (1.02 ± 0.45 versus 0.86 ± 0.34; P = 0.046). Stage, preoperative carcinoembryonic antigen level, V/S ratio, lymphatic invasion and perineural invasion were significantly associated with recurrence on univariate analysis, while only V/S ratio (P = 0.019; 95{\%} confidence interval, 1.22 to 9.09) was significantly associated with recurrence on multivariate analysis. Disease-free and overall survival of the obese group (V/S ratio > 1.0) were shorter than those of the non-obese group. Conclusions: V/S ratio is the optimal obesity index for predicting stage I–III MLRC recurrence.",
keywords = "Obesity, Rectal cancer, Visceral, Visceral fat area/subcutaneous fat area ratio",
author = "Lee, {Kang Hong} and Bo-kyeong Kang and Byungkyu Ahn",
year = "2018",
month = "9",
day = "1",
doi = "10.1007/s00384-018-3065-z",
language = "English",
volume = "33",
pages = "1303--1307",
journal = "International Journal of Colorectal Disease",
issn = "0179-1958",
number = "9",

}

TY - JOUR

T1 - Higher visceral fat area/subcutaneous fat area ratio measured by computed tomography is associated with recurrence and poor survival in patients with mid and low rectal cancers

AU - Lee, Kang Hong

AU - Kang, Bo-kyeong

AU - Ahn, Byungkyu

PY - 2018/9/1

Y1 - 2018/9/1

N2 - Purpose: Obesity is thought to influence postoperative complications and recurrence of mid and low rectal cancer (MLRC) because of intraoperative technical difficulties. However, few reports have described the relationship between obesity indices and the clinical outcomes of MLRC. This study aimed to investigate the association between visceral obesity on computed tomography (CT) and oncolofical outcomes after surgery for MLRC and identify the obesity index that most accurately reflects clinical outcomes. Methods: We investigated 125 patients who underwent curative resection for MLRC between 2004 and 2010. Visceral fat area (VFA) was defined as the umbilicus-level intra-abdominal adipose tissue area measured by CT. Body mass index (BMI), total fat area, VFA, subcutaneous fat area (SFA) and VFA/SFA ratio (V/S ratio) were analysed. Results: The median follow-up time was 60.3 months (range, 38.2–122.6 months). Recurrence was detected in 28 (22.4%) patients. Among the various obesity indices, recurrence was significantly associated with V/S ratio only (1.02 ± 0.45 versus 0.86 ± 0.34; P = 0.046). Stage, preoperative carcinoembryonic antigen level, V/S ratio, lymphatic invasion and perineural invasion were significantly associated with recurrence on univariate analysis, while only V/S ratio (P = 0.019; 95% confidence interval, 1.22 to 9.09) was significantly associated with recurrence on multivariate analysis. Disease-free and overall survival of the obese group (V/S ratio > 1.0) were shorter than those of the non-obese group. Conclusions: V/S ratio is the optimal obesity index for predicting stage I–III MLRC recurrence.

AB - Purpose: Obesity is thought to influence postoperative complications and recurrence of mid and low rectal cancer (MLRC) because of intraoperative technical difficulties. However, few reports have described the relationship between obesity indices and the clinical outcomes of MLRC. This study aimed to investigate the association between visceral obesity on computed tomography (CT) and oncolofical outcomes after surgery for MLRC and identify the obesity index that most accurately reflects clinical outcomes. Methods: We investigated 125 patients who underwent curative resection for MLRC between 2004 and 2010. Visceral fat area (VFA) was defined as the umbilicus-level intra-abdominal adipose tissue area measured by CT. Body mass index (BMI), total fat area, VFA, subcutaneous fat area (SFA) and VFA/SFA ratio (V/S ratio) were analysed. Results: The median follow-up time was 60.3 months (range, 38.2–122.6 months). Recurrence was detected in 28 (22.4%) patients. Among the various obesity indices, recurrence was significantly associated with V/S ratio only (1.02 ± 0.45 versus 0.86 ± 0.34; P = 0.046). Stage, preoperative carcinoembryonic antigen level, V/S ratio, lymphatic invasion and perineural invasion were significantly associated with recurrence on univariate analysis, while only V/S ratio (P = 0.019; 95% confidence interval, 1.22 to 9.09) was significantly associated with recurrence on multivariate analysis. Disease-free and overall survival of the obese group (V/S ratio > 1.0) were shorter than those of the non-obese group. Conclusions: V/S ratio is the optimal obesity index for predicting stage I–III MLRC recurrence.

KW - Obesity

KW - Rectal cancer

KW - Visceral

KW - Visceral fat area/subcutaneous fat area ratio

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U2 - 10.1007/s00384-018-3065-z

DO - 10.1007/s00384-018-3065-z

M3 - Article

C2 - 29713823

AN - SCOPUS:85051211764

VL - 33

SP - 1303

EP - 1307

JO - International Journal of Colorectal Disease

JF - International Journal of Colorectal Disease

SN - 0179-1958

IS - 9

ER -