Meta-analysis of the clinicopathological characteristics and peri-operative outcomes of colorectal cancer in obese patients

Rogers, Ailín C.; Handelman, Guy; Solon, J.G.; McNamara, Deborah A.; Deasy, Joseph; Burke, John P.

doi:10.1016/j.canep.2017.09.004

Cited by 8 publications

(10 citation statements)

References 58 publications

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“…Furthermore, we did not determine a relationship between tumor grade and BMI categories (p = 0.71). This finding is in line with the results of a meta-analysis that included 29 studies and found no significant difference in the CRC grade between obese and non-obese patients [11]. Meanwhile, a study conducted in Spain found that overweight and obese patients with colon cancer had more poorly differentiated tumors than their normal-weight counterparts.…”

Section: Discussionsupporting

confidence: 87%

“…In contrast, some studies found a significantly higher number of involved lymph nodes in obese patients with colon cancer than in patients with normal BMI [25]. In addition, a 2017 meta-analysis showed a higher probability of lymph node metastasis in patients who are obese than in those in lower BMI categories [11].…”

Section: Discussionmentioning

confidence: 95%

“…In addition to predisposing individuals to CRC, patients with obesity and CRC are found to have lower survival rates than those in other BMI groups [9,10]. A meta-analysis that compared outcomes between obese and non-obese patients undergoing surgery for CRC demonstrated a higher probability of lymph node metastases, lower lymph node yield, and more challenging resections in obese patients [11]. However, a recent study also found that overweight and obese patients were less likely to have advanced stages of CRC and had higher overall and cancer-specific survival rates [12].…”

Section: Introductionmentioning

confidence: 99%

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The Impact of Body Mass Index on the Clinicopathological and Prognostic Factors of Colorectal Cancer in Saudi Arabia

Aldaqal¹,

Maqbul²,

Alhammad³

et al. 2020

Cureus

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Background Obesity is a known risk factor of colorectal cancer (CRC); however, the relationship between obesity and clinicopathologic characteristics and prognosis of CRC remains unclear. This study aimed to investigate the relationship between body mass index (BMI) and clinicopathological and prognostic factors of CRC in Saudi Arabia. Method This was a retrospective cross-sectional study of patients with CRC diagnosed between 2014 and 2018 at King Abdulaziz University Hospital in Jeddah, Saudi Arabia. BMI was calculated by dividing the patient's weight in kilograms by height in meter squared and was classified according to the World Health Organization criteria. Statistical tests, including analysis of variance and chi-square tests, were used to investigate the relationship of each BMI category with clinicopathologic (histological type, degree of differentiation, tumor location, and medical comorbidities) and prognostic variables (TNM stage, lymph nodes involvement, and lymph nodes yield). Results Of 233 patients who were included, 60.1% were male and 39.9% were female patients, with a mean age (standard deviation) of 58.8 ± 13.7 (range: 26-99) years. The median BMI was 26.5 kg/m 2. Overall, 3%, 34.3%, 33.0%, and 29.6% patients were classified as underweight, normal weight, overweight, and obese, respectively. Furthermore, 57.1% (4/7), 39.2% (31/80), 38.7% (29/77), and 25.8% (17/69) of underweight, normal, overweight, and obese patients had Stage IV disease (p = 0.20). Of 16 patients with transverse colon cancer, 8 (50%) were obese (p = 0.38), and 1 (6%), 5 (31%), and 2 (13%) were underweight, normal weight, and overweight, respectively. Conclusion Underweight patients are more likely to present with metastatic CRC, while obese patients are more likely to present at earlier stages, although the difference was not statistically significant. BMI is not related to lymph node yield, histological type, or the degree of differentiation.

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Section: Discussionsupporting

confidence: 87%

Section: Discussionmentioning

confidence: 95%

Section: Introductionmentioning

confidence: 99%

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The Impact of Body Mass Index on the Clinicopathological and Prognostic Factors of Colorectal Cancer in Saudi Arabia

Aldaqal¹,

Maqbul²,

Alhammad³

et al. 2020

Cureus

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“…Focusing on oncologic colorectal surgery, a more recent meta‐analysis of 13 observational studies (4550 patients) reported significant increased conversion rate (OR: 2.11; 1.58–2.81), postoperative morbidity (OR: 1.54; 1.21–1.97), wound infection (OR: 2.43; 1.46–4.03), and anastomotic leak (OR: 1.65; 1.01–2.71) in the obese group 82 . On the contrary to what has been described for other cancers, 82–84 the rate of positive margin (distal and circumferential), 5‐year disease‐free and overall survival, 82 do not convincingly differ between normal‐weight and patients with obesity after laparoscopic, 82 or robotic, 84 surgery.…”

Section: Obesity and Colorectal Cancermentioning

confidence: 95%

“…Another recent meta‐analysis, including 29 studies totalling 56,293 patients, found an obesity rate of 19.3% among patients with cancer 83 . These patients with obesity were significantly more likely to have lymph node metastases (OR: 1.2; 1.1–1.2, p < 0.001), longer surgeries, more blood loss and conversions to open surgery (OR: 2.6; 1.6–4.0, p < 0.001), but there was no difference in length of stay or postoperative mortality 83 …”

Section: Obesity and Colorectal Cancermentioning

confidence: 99%

Review article: obesity and colorectal cancer

Bardou

Rouland

Martel

et al. 2022

Aliment Pharmacol Ther

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Summary Background Obesity is a growing global public health problem. More than half the European and North American population is overweight or obese. Colon and rectum cancers are still the second leading cause of cancer death worldwide, and epidemiological data support an association between obesity and colorectal cancers (CRCs). Aim To review the literature on CRC epidemiology in obese subjects, assessing the effects of obesity, including childhood or maternal obesity, on CRC, diagnosis, management, and prognosis, and discussing targeted prophylactic measures. Method We searched PubMed for obesity/overweight/metabolic syndrome and CRC. Other key words included ‘staging’, ‘screening’, ‘treatment’, ‘weight loss’, ‘bariatric surgery’ and ‘chemotherapy’. Results In Europe, about 11% of CRCs are attributed to overweight and obesity. Epidemiological data suggest that obesity is associated with a 30%–70% increased risk of colon cancer in men, the association being less consistent in women. Visceral fat or abdominal obesity seems to be of greater concern than subcutaneous fat obesity, and any 1 kg/m2 increase in body mass index confers more risk (hazard ratio 1.03). Obesity might increase the likelihood of recurrence or mortality of the primary cancer and may affect initial management, including accurate staging. The risk maybe confounded by different factors, including lower adherence to organised CRC screening programmes. It is unclear whether bariatric surgery helps reduce rectal cancer risk. Conclusions Despite a growing body of evidence linking obesity to CRC, many questions remain unanswered, including whether we should screen patients with obesity earlier or propose prophylactic bariatric surgery for certain patients with obesity.

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