Visceral obesity, body mass index and risk of complications after colon cancer resection: A retrospective cohort study

Cakir, Hamit; Heus, Colin; Verduin, Wouter M.; Lak, A. Rafie; Doodeman, Hiëronymus J.; Bemelman, Willem A.; Houdijk, Alexander P. J.

doi:10.1016/j.surg.2014.12.012

Cited by 54 publications

(45 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The VFA to SFA ratio (V/S) was computed as a parameter for visceral adiposity as previously described. 16 The threshold for elevated V/S was set at 0.4 16, 26, 27 while visceral fat area (VFA) greater than 100 cm 2 was selected 2, 15, 17, 18 . The error rate was set at 0.5% as previously described 25, 27 .…”

Section: Methodsmentioning

confidence: 99%

“…Besides metabolic syndrome, excess visceral fat is thought to predispose to chronic inflammation and release of growth factors that mediate colonic neoplasia 10, 11 . Conventional methods for estimating intra-abdominal fat include waist circumference and waist-to-hip ratio 12, 13 and BMI, but they do not clearly distinguish subcutaneous fat distribution from visceral fat 6, 14, 15 .…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Quantitative Assessment of Visceral Obesity and Postoperative Colon Cancer Outcomes

Ozoya

Siegel

Srikumar

et al. 2017

Journal of Gastrointestinal Surgery

View full text Add to dashboard Cite

Background Quantitative computed tomography (CT) assessment of visceral adiposity may be superior to body mass index (BMI) as a predictor of surgical morbidity. We sought to examine the association of CT measures of obesity and BMI with short-term post-operative outcomes in colon cancer patients. Methods In this retrospective study, 110 patients treated with colectomy for Stage I–III colon cancer were classified as obese or non-obese by pre-operative CT-based measures of adiposity or BMI. [Obese: BMI≥30kg/m2, visceral fat area (VFA) to subcutaneous fat area ratio (V/S) ≥0.4 and VFA>100cm2)]. Post-operative morbidity and mortality rates were compared. Results Obese patients, by V/S and VFA but not BMI, were more likely to be male and have pre-existing hypertension and diabetes. The overall complication rate was 25.5% and there were no mortalities. Obese patients by VFA (with a trend for VS but not BMI) were more likely to develop postoperative complications as compared to patients classified as non-obese; VFA (30.5% vs.10.7%, p= 0.03), VS (29.2% vs. 9.5%, p=0.05) and BMI (32.4% vs. 21.9%, p=0.23). Conclusions Elevated visceral obesity quantified by CT is associated with the presence of key metabolic comorbidities and increased post-operative morbidity and may be superior to BMI for risk stratification.

show abstract

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Quantitative Assessment of Visceral Obesity and Postoperative Colon Cancer Outcomes

Ozoya

Siegel

Srikumar

et al. 2017

Journal of Gastrointestinal Surgery

View full text Add to dashboard Cite

show abstract

“…For example, patients with low BMI might still be viscerally obese. In an interesting observation by Cakir et al, visceral obesity was noted to be a predictor of worse outcome after surgery in patients with resectable colon cancer [30]. However, outcomes were worse among patients with BMI <25 kg/m 2 , although up to 44% in this group also had visceral obesity [30].…”

mentioning

confidence: 95%

“…In an interesting observation by Cakir et al, visceral obesity was noted to be a predictor of worse outcome after surgery in patients with resectable colon cancer [30]. However, outcomes were worse among patients with BMI <25 kg/m 2 , although up to 44% in this group also had visceral obesity [30]. In another study, while only 3.2% of the patients met the criteria for obesity (BMI >30 kg/m 2 ), more than two-thirds of the patients met the criteria for visceral obesity [31].…”

mentioning

confidence: 95%

“…So it is not only the 'general obesity' but also the 'abdominal obesity' that can be assessed with clinical measurements like waist-to-hip ratio or waist circumference that may be determining outcomes in these patients [9]. Incorporating surrogate radiological measures is also an accurate and cost-effective method, as patients with colon cancer might receive several CT scans during the course of their disease [30,32]. Furthermore, it is important to note that a proportion of overweight/obese patients may still be 'metabolically healthy' (normal glucose tolerance, lipid levels, and blood pressure as well as less ectopic fat) compared with those with 'metabolic dysfunction,' with overall higher risk and poorer outcomes in the latter group [26].…”

mentioning

confidence: 99%

See 1 more Smart Citation

Is obesity an advantage in patients with colorectal cancer?

Kasi

Zafar²,

Grothey

2015

Expert Review of Gastroenterology & Hepatology

View full text Add to dashboard Cite

Visceral obesity is a preoperative risk factor for postoperative ileus after surgery for colorectal cancer: Single‐institution retrospective analysis

Morimoto

Takahashi

Fujii

et al. 2019

Annals of Gastroent Surgery

View full text Add to dashboard Cite

Aim: Visceral obesity (VO) reportedly has a stronger association with complications after colorectal surgery than does body mass index. Here, we retrospectively assessed VO as a risk factor for postoperative ileus (POI) after colorectal resection in patients with colorectal cancer.Methods: This study included 417 consecutive patients with colorectal cancer who underwent elective surgery at our institute from January 2010 to December 2012.Visceral fat area (VFA) was calculated by image analysis software. VO was defined as VFA ≥100 cm 2 . We assessed 49 factors, including VO, comorbidities, surgical procedure, and postoperative complications. Data were analyzed using a propensity scorematching strategy.Results: Postoperative ileus occurred in 18 patients (4.3%) from the entire cohort, and in 14 (5.5%) of the 256 matched patients. Multivariate analysis (n = 417 patients) showed that significant risk factors for POI included VO (OR 7.9, 95% confidence interval [CI] 1.9-32.1, P = .004), open surgery (OR 6.4, 95% CI 1.6-26.7, P = .010), and pelvic/intra-abdominal abscess (OR 11.0, 95% CI 1.1-110.2, P = .041). Propensity score matching showed two independent risk factors in the multivariate analysis: VO (OR 6.2, 95% CI 1.3-30.4, P = .025) and open surgery (OR 9.1, 95% CI 2.0-40.5, P = .004). Conclusion:Visceral obesity may be an independent risk factor for POI in patients with colorectal cancer. K E Y W O R D Scolorectal cancer, ileus, obesity, postoperative complication, surgery

show abstract

Visceral obesity, body mass index and risk of complications after colon cancer resection: A retrospective cohort study

Cited by 54 publications

References 22 publications

Quantitative Assessment of Visceral Obesity and Postoperative Colon Cancer Outcomes

Quantitative Assessment of Visceral Obesity and Postoperative Colon Cancer Outcomes

Is obesity an advantage in patients with colorectal cancer?

Visceral obesity is a preoperative risk factor for postoperative ileus after surgery for colorectal cancer: Single‐institution retrospective analysis

Contact Info

Product

Resources

About