Impact of Body Composition on Surgical Outcome in Rectal Cancer Patients, a Retrospective Cohort Study

Overview

Journal World J Surg

Publisher Wiley

Specialty General Surgery

Date 2019 Feb 6

PMID 30719554

Citations 14

Authors

C Heus

N Bakker

W M Verduin

H J Doodeman

A P J Houdijk

Affiliations

Soon will be listed here.

Abstract

Background: Obesity is becoming a bigger health problem every year. Current research shows that the obesity-related metabolic problems are strongly associated with visceral fat and not subcutaneous fat. Visceral obesity (VO) is associated with a worse postoperative outcome in multiple fields of abdominal surgery. On the other hand, muscle mass is related to better postoperative outcome. In rectal cancer patients, we studied the influence of visceral obesity and muscle mass on postoperative complications.

Methods: The visceral fat area (VFA) and skeletal muscle area (SMA) were determined on preoperative CT scans in 406 patients. The preoperative comorbidity, per-operative outcome and postoperative complications were extracted retrospectively from the patient files. VO was defined as a VFA > 100 cm. Correlations between body composition, postoperative complications and LOS were studied.

Results: In our study, 67% of the patients were classified as visceral obese. Mean body mass index (BMI) was higher in the VO group (26.6 ± 3.5 vs 23.5 ± 2.8; p < 0.001). Visceral obese patients had a higher prevalence of cardiac comorbidity (29% vs 13% p = 0.001), hypertension (36% vs 20% p = 0.002) and diabetes mellitus (16% vs 5% p = 0.002). In addition, VO patients had more operative blood loss (431 vs 310 mL; p = 0.008), longer operating time (166 vs 149 min p = 0.003) and more wound infections (14% vs 8% p = 0.048). Visceral obesity was associated with more complications (OR: 1.63 p = 0.043) and longer LOS (risk estimate: 1.18 p = 0.009).

Conclusion: VO patients more often had a history of cardiac disease, hypertension and diabetes mellitus. Visceral obesity correlated with a worse outcome after surgery for rectal cancer.

Citing Articles

Association of computed tomography-derived body composition and complications after colorectal cancer surgery: A systematic review and meta-analysis.

van Helsdingen C, van Wijlick J, de Vries R, Bouvy N, Leeflang M, Hemke R J Cachexia Sarcopenia Muscle. 2024; 15(6):2234-2269.

PMID: 39370740 PMC: 11634520. DOI: 10.1002/jcsm.13580.

Deep pelvis and low visceral fat mass as risk factors for neurogenic bladder after rectal cancer surgery.

Matsui T, Kiuchi J, Kuriu Y, Arita T, Shimizu H, Nanishi K BMC Gastroenterol. 2024; 24(1):323.

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Predictive modeling based on tumor spectral CT parameters and clinical features for postoperative complications in patients undergoing colon resection for cancer.

Tan X, Yang X, Hu S, Chen X, Sun Z Insights Imaging. 2023; 14(1):155.

PMID: 37741813 PMC: 10517912. DOI: 10.1186/s13244-023-01515-5.

Does the visceral fat area impact the histopathology specimen metrics after total mesorectal excision for distal rectal cancer?.

Gachabayov M, Felsenreich D, Bhatti S, Bergamaschi R Langenbecks Arch Surg. 2023; 408(1):257.

PMID: 37389686 DOI: 10.1007/s00423-023-02981-7.

A meta-analysis of the effect of different body mass index on surgical wound infection after colorectal surgery.

Liu J, Li G, Chen Z, Jiang H Int Wound J. 2023; 20(6):2151-2158.

PMID: 36860168 PMC: 10333030. DOI: 10.1111/iwj.14091.

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