Oncologic evaluation of obesity as a factor in patients with rectal cancer undergoing laparoscopic surgery

A propensity-matched analysis using body mass index

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Purpose: This study evaluated the oncologic impact of obesity, as determined by body mass index (BMI), in patients who underwent laparoscopic surgery for rectal cancer. Methods: The records of 483 patients with stage I–III rectal cancer who underwent laparoscopic surgery between June 2003 and December 2011 were reviewed. A matching model based on BMI was constructed to balance obese and nonobese patients. Cox hazard regression models for overall survival (OS) and disease-free survival (DFS) were used for multivariate analyses. Additional analysis using visceral fat area (VFA) measurement was performed for matched patients. The threshold for obesity was BMI ≥ 25 kg/m2 or VFA ≥ 130 cm2. Results: The score matching model yielded 119 patients with a BMI ≥ 25 kg/m2 (the obese group) and 119 patients with a BMI < 25 kg/m2 (the nonobese group). Surgical outcomes including operation time, estimated blood loss, nil per os periods, and length of hospital stay did not differ between the obese and the nonobese group. The retrieved lymph node numbers and pathologic CRM positive rate were also similar in between the 2 groups. After a median follow-up of 48 months (range, 3–126 months), OS and DFS rates were similar between the 2 groups. A tumor location-adjusted model for overall surgical complications showed that a BMI ≥ 25 kg/m2 were not risk factors. Multivariable analyses for OS and DFS showed no significant association with a BMI ≥ 25 kg/m2. Conclusion: Obesity was not associated with long-term oncologic outcomes in patients undergoing laparoscopic surgery for rectal cancer in the Asian population.

Original languageEnglish
Pages (from-to)86-94
Number of pages9
JournalAnnals of Surgical Treatment and Research
Volume96
Issue number2
DOIs
StatePublished - 1 Feb 2019

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Rectal Neoplasms
Laparoscopy
Body Mass Index
Obesity
Disease-Free Survival
Intra-Abdominal Fat
Length of Stay
Anatomic Models
Survival
Survival Analysis
Proportional Hazards Models
Multivariate Analysis
Survival Rate
Lymph Nodes
Population
Neoplasms

Keywords

  • Body mass index
  • Laparoscopy
  • Rectal neoplasms

Cite this

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title = "Oncologic evaluation of obesity as a factor in patients with rectal cancer undergoing laparoscopic surgery: A propensity-matched analysis using body mass index",
abstract = "Purpose: This study evaluated the oncologic impact of obesity, as determined by body mass index (BMI), in patients who underwent laparoscopic surgery for rectal cancer. Methods: The records of 483 patients with stage I–III rectal cancer who underwent laparoscopic surgery between June 2003 and December 2011 were reviewed. A matching model based on BMI was constructed to balance obese and nonobese patients. Cox hazard regression models for overall survival (OS) and disease-free survival (DFS) were used for multivariate analyses. Additional analysis using visceral fat area (VFA) measurement was performed for matched patients. The threshold for obesity was BMI ≥ 25 kg/m2 or VFA ≥ 130 cm2. Results: The score matching model yielded 119 patients with a BMI ≥ 25 kg/m2 (the obese group) and 119 patients with a BMI < 25 kg/m2 (the nonobese group). Surgical outcomes including operation time, estimated blood loss, nil per os periods, and length of hospital stay did not differ between the obese and the nonobese group. The retrieved lymph node numbers and pathologic CRM positive rate were also similar in between the 2 groups. After a median follow-up of 48 months (range, 3–126 months), OS and DFS rates were similar between the 2 groups. A tumor location-adjusted model for overall surgical complications showed that a BMI ≥ 25 kg/m2 were not risk factors. Multivariable analyses for OS and DFS showed no significant association with a BMI ≥ 25 kg/m2. Conclusion: Obesity was not associated with long-term oncologic outcomes in patients undergoing laparoscopic surgery for rectal cancer in the Asian population.",
keywords = "Body mass index, Laparoscopy, Rectal neoplasms",
author = "Son, {Il Tae} and Duck-Woo Kim and Choe, {Eun Kyung} and Kim, {Young Hoon} and Kyoungho Lee and Ahn, {So Yeon} and Kang, {Sung Il} and Kim, {Myung Jo} and Oh, {Heung Kwon} and Jae-Sung Kim and Kang, {Sung Bum}",
year = "2019",
month = "2",
day = "1",
doi = "10.4174/astr.2019.96.2.86",
language = "English",
volume = "96",
pages = "86--94",
journal = "Annals of Surgical Treatment and Research",
issn = "2288-6575",
publisher = "Korean Surgical Society",
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}

TY - JOUR

T1 - Oncologic evaluation of obesity as a factor in patients with rectal cancer undergoing laparoscopic surgery

T2 - A propensity-matched analysis using body mass index

AU - Son, Il Tae

AU - Kim, Duck-Woo

AU - Choe, Eun Kyung

AU - Kim, Young Hoon

AU - Lee, Kyoungho

AU - Ahn, So Yeon

AU - Kang, Sung Il

AU - Kim, Myung Jo

AU - Oh, Heung Kwon

AU - Kim, Jae-Sung

AU - Kang, Sung Bum

PY - 2019/2/1

Y1 - 2019/2/1

N2 - Purpose: This study evaluated the oncologic impact of obesity, as determined by body mass index (BMI), in patients who underwent laparoscopic surgery for rectal cancer. Methods: The records of 483 patients with stage I–III rectal cancer who underwent laparoscopic surgery between June 2003 and December 2011 were reviewed. A matching model based on BMI was constructed to balance obese and nonobese patients. Cox hazard regression models for overall survival (OS) and disease-free survival (DFS) were used for multivariate analyses. Additional analysis using visceral fat area (VFA) measurement was performed for matched patients. The threshold for obesity was BMI ≥ 25 kg/m2 or VFA ≥ 130 cm2. Results: The score matching model yielded 119 patients with a BMI ≥ 25 kg/m2 (the obese group) and 119 patients with a BMI < 25 kg/m2 (the nonobese group). Surgical outcomes including operation time, estimated blood loss, nil per os periods, and length of hospital stay did not differ between the obese and the nonobese group. The retrieved lymph node numbers and pathologic CRM positive rate were also similar in between the 2 groups. After a median follow-up of 48 months (range, 3–126 months), OS and DFS rates were similar between the 2 groups. A tumor location-adjusted model for overall surgical complications showed that a BMI ≥ 25 kg/m2 were not risk factors. Multivariable analyses for OS and DFS showed no significant association with a BMI ≥ 25 kg/m2. Conclusion: Obesity was not associated with long-term oncologic outcomes in patients undergoing laparoscopic surgery for rectal cancer in the Asian population.

AB - Purpose: This study evaluated the oncologic impact of obesity, as determined by body mass index (BMI), in patients who underwent laparoscopic surgery for rectal cancer. Methods: The records of 483 patients with stage I–III rectal cancer who underwent laparoscopic surgery between June 2003 and December 2011 were reviewed. A matching model based on BMI was constructed to balance obese and nonobese patients. Cox hazard regression models for overall survival (OS) and disease-free survival (DFS) were used for multivariate analyses. Additional analysis using visceral fat area (VFA) measurement was performed for matched patients. The threshold for obesity was BMI ≥ 25 kg/m2 or VFA ≥ 130 cm2. Results: The score matching model yielded 119 patients with a BMI ≥ 25 kg/m2 (the obese group) and 119 patients with a BMI < 25 kg/m2 (the nonobese group). Surgical outcomes including operation time, estimated blood loss, nil per os periods, and length of hospital stay did not differ between the obese and the nonobese group. The retrieved lymph node numbers and pathologic CRM positive rate were also similar in between the 2 groups. After a median follow-up of 48 months (range, 3–126 months), OS and DFS rates were similar between the 2 groups. A tumor location-adjusted model for overall surgical complications showed that a BMI ≥ 25 kg/m2 were not risk factors. Multivariable analyses for OS and DFS showed no significant association with a BMI ≥ 25 kg/m2. Conclusion: Obesity was not associated with long-term oncologic outcomes in patients undergoing laparoscopic surgery for rectal cancer in the Asian population.

KW - Body mass index

KW - Laparoscopy

KW - Rectal neoplasms

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U2 - 10.4174/astr.2019.96.2.86

DO - 10.4174/astr.2019.96.2.86

M3 - Article

VL - 96

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JO - Annals of Surgical Treatment and Research

JF - Annals of Surgical Treatment and Research

SN - 2288-6575

IS - 2

ER -