Elevated visceral obesity quantified by CT is associated with adverse postoperative outcome of laparoscopic radical nephrectomy for renal clear cell carcinoma patients

Zhai, Ting‐Shuai; Zhang, Bocheng; Qu, Zhenan; Chen, Chen

doi:10.1007/s11255-018-1858-1

Cited by 28 publications

(33 citation statements)

References 24 publications

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“…Obesity increases the risk inherent to major gastrointestinal surgeries [33] and is a confounding risk factor for surgical morbidity in patients undergoing pancreatic resection [15,34]. More precisely, visceral obesity is a major factor that increases postoperative complications [35,36]. Difficult manipulation, poor laparoscopic view, prolonged operative time, and the presence of a fatty or friable pancreas are related to visceral obesity and can be risk factors for postoperative complications [37,38].…”

Section: Discussionmentioning

confidence: 99%

Predictive Factors Associated with Complications after Laparoscopic Distal Pancreatectomy

Song

Hong

Kim

et al. 2020

JCM

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Although laparoscopic distal pancreatectomy (LDP) has become more popular, the postoperative complication rate remains high. We sought to identify the risk factors for post-LDP complications. We examined 1227 patients who underwent LDP between March 2005 and December 2015 at a single large-volume center. We used logistic regression for the analysis. The overall (13.2%) and major (3.3%) complication rates were determined. Postoperative pancreatic fistula was the most frequent complication, and 58 patients (4.7%) had clinically significant (grade B) pancreatic fistulas. No 90-day mortality was recorded. Long operative time (≥200 min), large estimated blood loss (≥320 mL), LDP performed by an inexperienced surgeon (<50 cases), and concomitant splenectomy were identified as risk factors for overall complications using a logistic regression model. For major complications, male sex (p = 0.020), long operative time (p = 0.005), and LDP performed by an inexperienced surgeon (p = 0.026) were significant predictive factors. Using logistic regression analysis, surgery-related factors, including long operative time and LDP performed by an inexperienced surgeon, were correlated with overall and major complications of LDP. As LDP is a technically challenging procedure, surgery-related variables emerged as the main risk factors for postoperative complications. Appropriate patient selection and sufficient surgeon experience may be essential to reduce the complications of LDP.

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Section: Discussionmentioning

confidence: 99%

Predictive Factors Associated with Complications after Laparoscopic Distal Pancreatectomy

Song

Hong

Kim

et al. 2020

JCM

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“…29 Compared with BMI, body fat composition (such as VFA, SFA, and TFA), as a quantitative method by CT image, has recently been focused on its contributions to the progression of RCC. 6,7 However, the relationship between body fat composition and tumor progression and patients' survival still failed to reach an agreement in different disease stages. Zhu et al reported a positive correlation between the percentage of visceral adipose tissue and the Fuhrman tumor grade in patients with T1a RCC.…”

Section: Discussionmentioning

confidence: 99%

“…[3][4][5] Over the last decade, obesity has been shown to be associated with increased renal cell carcinoma (RCC) risk and the prognosis of patients. [5][6][7] Body fat accumulation, as one of the important parameters of obesity, which could be measured from a routine computed tomography (CT) image, has recently shown its contribution to the survival of RCC patients. [8][9][10] Several studies have suggested that visceral fat accumulation (VFA) be involved in the prognostic risk stratification.…”

Section: Introductionmentioning

confidence: 99%

The prognostic value of body fat components in metastasis renal cell carcinoma patients treated with TKIs.

Dai

Zhang

Liu

et al. 2020

JCO

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668 Background: To assess the association between body fat components and survival status and tumor response for metastatic renal cell carcinoma (mRCC) patients treated with tyrosine kinase inhibitors (TKIs). Methods: Patients with pathologically diagnosed and radiologically indicated mRCC were enrolled into the retrospective study. Three body fat components: total fat accumulation (TFA), visceral fat accumulation (VFA) and subcutaneous fat accumulation (SFA) were measured using standard CT scans. The clinical outcomes included progression-free survival (PFS), overall survival (OS), and tumor response rates. Univariate analysis and multivariate Cox proportion hazard regression models were used to find associated parameters and to calculate the adjusted hazard ratio (HR). Results: A total of 146 patients were enrolled. The median follow-up time was 22 months. According to the univariate analysis, patients with an increased SFA and TFA had a longer PFS and OS. A similar phenomenon was observed among patients with ≥2 increasing body fat components about PFS and OS. As for multivariate analysis, SFA change (p=0.014) or the number of increasing body fat components (p=0.040) were independent indicators to predict PFS. In addition, SFA change (p=0.022) or the number of increasing body fat components (p=0.008) could independently predict OS. Moreover, a better disease control rate (p=0.028) was founded in patients with ≥2 increasing components. In the subgroup of patients with ≥2 metastasis sites, improved OS (p=0.017) and PFS (p=0.027) were found compared to those with <2 increasing components. Further multivariate analysis identified the number of increasing body fat components was an independent factor in predicting PFS (p=0.018) and OS (p=0.029). Conclusions: Body fat accumulation, such as high SFA or TFA at progression, could improve the survival of patients with mRCC treated with TKIs, especially patients with higher tumor burden. It should be considered as an important parameter to predict the survival status of patients with mRCC.

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“…It has been suggested that corporeity may influence short‐term surgical outcomes in addition to surgical techniques and perioperative care protocols. Recent studies have emphasized the influence of visceral obesity on perioperative and short‐term postoperative outcomes in patients surgically treated . Body mass index (BMI), considered as a conventional tool to assess obesity, can be easily calculated, but it cannot estimate body fat distribution accurately .…”

Section: Introductionmentioning

confidence: 99%

Elevated visceral fat area is associated with adverse postoperative outcome of radical colectomy for colon adenocarcinoma patients

Zhai

Kang

Ren

et al. 2019

ANZ Journal of Surgery

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Objective: To assess the impact of visceral obesity quantified by preoperative computed tomography on short-term postoperative outcomes compared with body mass index (BMI) in stage I-III colon adenocarcinoma patients. Methods: In this retrospective study, 107 patients treated with radical colectomy for stage I-III colon adenocarcinoma were classified as obese or non-obese by computed tomography-based measures or BMI (obese: BMI ≥28 kg/m 2 , visceral fat area (VFA) to subcutaneous fat area ratio (V/S) ≥0.4, and VFA ≥100 cm 2 ). Clinical variables, operation time, estimated blood loss, pathologic stage, histologic grade, postoperative complications, postoperative stay and hospitalization expenses were compared. Results: Obese patients by VFA were more likely to have higher postoperative complication rate (32.9 versus 11.8%, P = 0.021), have longer operation time (184.6 AE 49.5 versus 163.1 AE 44.1 min, P = 0.033), postoperative stay (15.21 AE 7.59 versus 12.29 AE 5.40 days, P = 0.047) and cost more ($10 758.7 AE 3271.7 versus $9232.0 AE 2994.6, P = 0.023) than non-obese. Conclusion: Visceral obesity graded by VFA is associated with increased postoperative morbidity, operation time, postoperative stay and hospitalization expenses for colon adenocarcinoma patients and may be superior to BMI or V/S for the prediction of colon surgery.

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Elevated visceral obesity quantified by CT is associated with adverse postoperative outcome of laparoscopic radical nephrectomy for renal clear cell carcinoma patients

Cited by 28 publications

References 24 publications

Predictive Factors Associated with Complications after Laparoscopic Distal Pancreatectomy

Predictive Factors Associated with Complications after Laparoscopic Distal Pancreatectomy

The prognostic value of body fat components in metastasis renal cell carcinoma patients treated with TKIs.

Elevated visceral fat area is associated with adverse postoperative outcome of radical colectomy for colon adenocarcinoma patients

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