Quantitative Assessment of Visceral Obesity and Postoperative Colon Cancer Outcomes

• Published in: Journal of gastrointestinal surgery Vol. 21; no. 3; pp. 534 - 542
• Main Authors: Ozoya, Oluwatobi O., Siegel, Erin M., Srikumar, Thejal, Bloomer, Amanda M., DeRenzis, Amanda, Shibata, David
• Format: Journal Article
• Language: English
• Published: New York Springer US 01.03.2017; Springer Nature B.V
• Subjects: Aged; Body fat; Body Mass Index; Colectomy - adverse effects; Colectomy - statistics & numerical data; Colonic Neoplasms - complications; Colonic Neoplasms - surgery; Comorbidity; Female; Gastroenterology; Humans; Intra-Abdominal Fat - diagnostic imaging; Male; Medicine; Medicine & Public Health; Middle Aged; Obesity; Obesity, Abdominal - complications; Obesity, Abdominal - diagnostic imaging; Original Article; Retrospective Studies; Risk Assessment; Risk Factors; Subcutaneous Fat - diagnostic imaging; Surgery; Surgical outcomes; Tomography, X-Ray Computed; Treatment Outcome; United States > US; Colon cancer; Computed tomography; Surgical complication; Visceral obesity
• ISSN: 1091-255X; 1873-4626
• DOI: 10.1007/s11605-017-3362-9

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 postoperative 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 preoperative CT-based measures of adiposity or BMI [obese: BMI ≥ 30 kg/m 2 , visceral fat area (VFA) to subcutaneous fat area ratio ( V / S ) ≥0.4, and VFA > 100 cm 2 ]. Postoperative 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 preexisting hypertension and diabetes. The overall complication rate was 25.5%, and there were no mortalities. Obese patients by VFA (with a trend for V / S 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), V / S (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 postoperative morbidity and may be superior to BMI for risk stratification.