Visceral Obesity May Affect Oncologic Outcome in Patients with Colorectal Cancer

Moon, Hyeong‐Gon; Ju, Young Tae; Jeong, Chi Young; Jung, Eun Jung; Lee, Young Joon; Hong, Soon Chan; Ha, Woo Song; Park, Soon Tae; Choi, Sang Kyung

doi:10.1245/s10434-008-9891-4

Cited by 170 publications

(154 citation statements)

References 18 publications

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“…Recent epidemiological studies have found that abdominal adiposity, in particular the presence of a large VAT compartment, is an important risk factor for cancer development and results in poor prognosis. [16][17][18][19][20] These findings suggest therefore that adipose tissue distribution may be an independent prognostic factor in patients treated curatively for localized prostate cancer. The prognostic significance of abdominal fat distribution in patients with prostate cancer treated with EBRT on Gleason score (GS), prostate-specific antigen (PSA) or clinical stage and outcomes, has not yet been studied.…”

Section: -14mentioning

confidence: 85%

Prognostic impact of abdominal adiposity, waist circumference and body mass index in patients with intermediate-risk prostate cancer treated with radiotherapy

Zilli

Nguyễn

et al. 2011

Int J Obes

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Objective: We tested the potential role of abdominal visceral (VAT) and subcutaneous (SAT) adipose tissues, waist circumference (WC) and body mass index (BMI) as prognostic factors in patients with intermediate-risk prostate cancer (clinical stage T1b-2b, and Gleason Score (GS) ¼ 7 and prostate-specific antigen PSA level o15 ng ml À1 , or GS p6 and PSA between 10 and 20 ng ml À1 ) treated with ultrasound-based image-guided radiotherapy. Methods: VAT, SAT and WC (measured from planning abdominal computed tomography) and BMI were compared with clinical and pathologic factors using univariate analyses. Cox regression analyses were performed to evaluate whether obesity indices significantly predicted biochemical disease free-survival (bDFS). Results: Of the 112 eligible patients, 30 (27%) were obese. Median BMI at baseline was 27.5 kg m À2 (range, 19.2-51.5 kg m À2 ). Greater abdominal adiposity, WC and BMI were significantly associated with younger age at diagnosis and increased prostate volume (P ¼ 0.003 and P ¼ 0.002, respectively). No significant correlation between obesity measures and T-stage, GS, PSA or percentage of positive cores at biopsy was found. On Cox regression analyses, none of the obesity measures predicted for bDFS. No association was observed between obesity indices and surrogate markers of biochemical failure as PSA nadir (nPSA) or time to nPSA. Conclusions: Abdominal adiposity, WC and BMI are associated with younger age at diagnosis and greater prostate volume but not with an increased risk of biochemical failure in patients with intermediate-risk prostate cancer.

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Section: -14mentioning

confidence: 85%

Prognostic impact of abdominal adiposity, waist circumference and body mass index in patients with intermediate-risk prostate cancer treated with radiotherapy

Zilli

Nguyễn

et al. 2011

Int J Obes

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“…Many population studies (for example Pietinen et al (1999), Calle et al (2003), Meyerhardt et al (2003Meyerhardt et al ( , 2007, Dignam et al (2006) and Moon et al (2008)) provide evidence that excess energy intake and/or obesity is associated with increased risk of colorectal cancer and/or with poor prognosis of this disease. Further epidemiological evidence (Ma et al 2004, Wei et al 2005, Wolpin et al 2009) suggests the hypothesis that one of the underlying mechanisms involves stimulation of malignant proliferation by insulin.…”

Section: Introductionmentioning

confidence: 99%

Metformin blocks the stimulative effect of a high-energy diet on colon carcinoma growth in vivo and is associated with reduced expression of fatty acid synthase

Algire¹,

Amrein²,

Zakikhani³

et al. 2010

Endocrine-Related Cancer

205

158

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The molecular mechanisms responsible for the association of obesity with adverse colon cancer outcomes are poorly understood. We investigated the effects of a high-energy diet on growth of an in vivo colon cancer model. Seventeen days following the injection of 5!10 5 MC38 colon carcinoma cells, tumors from mice on the high-energy diet were approximately twice the volume of those of mice on the control diet. These findings were correlated with the observation that the highenergy diet led to elevated insulin levels, phosphorylated AKT, and increased expression of fatty acid synthase (FASN) by the tumor cells. Metformin, an antidiabetic drug, leads to the activation of AMPK and is currently under investigation for its antineoplastic activity. We observed that metformin blocked the effect of the high-energy diet on tumor growth, reduced insulin levels, and attenuated the effect of diet on phosphorylation of AKT and expression of FASN. Furthermore, the administration of metformin led to the activation of AMPK, the inhibitory phosphorylation of acetyl-CoA carboxylase, the upregulation of BNIP3 and increased apoptosis as estimated by poly (ADP-ribose) polymerase (PARP) cleavage. Prior work showed that activating mutations of PI3K are associated with increased AKT activation and adverse outcome in colon cancer; our results demonstrate that the aggressive tumor behavior associated with a high-energy diet has similar effects on this signaling pathway. Furthermore, metformin is demonstrated to reverse the effects of the high-energy diet, thus suggesting a potential role for this agent in the management of a metabolically defined subset of colon cancers.

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“…Similarly Seki et al, in a retrospective study investigating the impact of visceral fat on operation time, reported that VFA/BSA may be a more useful index than BMI in predicting technical difficulty of performing a laparoscopic resection of rectosigmoid carcinoma (27). In a study investigating the prognostic significance of visceral obesity and BMI in 161 resectable colorectal cancer patients, Moon et al reported that increased visceral adiposity was a significant predictor of disease-free survival in patients with resectable colorectal cancer (28).…”

Section: Discussionmentioning

confidence: 99%

CT-based assessment of visceral adiposity and outcomes for esophageal adenocarcinoma

Saeed¹,

Shridhar²,

Almhanna³

et al. 2017

J. Gastrointest. Oncol.

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Background: Various methods of quantifying and correlating obesity to outcomes for patients with esophageal adenocarcinoma (EA) have been evaluated. Published data suggest that quantification of adiposity may be more accurate than body mass index (BMI) as a prognostic factor. We report our analysis of adiposity as a prognostic factor in a series of patients with EA. to −130. Outcomes were analyzed using Kaplan-Meier method and log-rank analysis. Multivariate analysis (MVA) was performed using the Cox proportion hazard regression model. Results:We identified 126 patients for the analysis. There were no statistically significant differences in overall survival or disease-free survival between groups above and below the medians for TFA, SFA, or VFA/SFA ratio. However, an increase in VFA was significantly associated with worsened OS and DFS when we further classified patients into quartiles. Patients with VFA ≥182 cm² had larger tumor size (P=0.016), fewer involved lymph nodes (P=0.047), longer operating times (P=0.032), and were more likely to be males (P=0.042).Conclusions: Published data have demonstrated an association between treatment outcomes and degree of adiposity; our study found a correlation between VFA and OS and DFS in patients with EA. Median TFA, SFA, and VFA/SFA were not prognostic on MVA. While VFA >182 cm 2 was associated with larger tumors, there were also fewer lymph nodes harvested in this group.

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Visceral Obesity May Affect Oncologic Outcome in Patients with Colorectal Cancer

Cited by 170 publications

References 18 publications

Prognostic impact of abdominal adiposity, waist circumference and body mass index in patients with intermediate-risk prostate cancer treated with radiotherapy

Prognostic impact of abdominal adiposity, waist circumference and body mass index in patients with intermediate-risk prostate cancer treated with radiotherapy

Metformin blocks the stimulative effect of a high-energy diet on colon carcinoma growth in vivo and is associated with reduced expression of fatty acid synthase

CT-based assessment of visceral adiposity and outcomes for esophageal adenocarcinoma

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