Visceral Obesity Predicts Fewer Lymph Node Metastases and Better Overall Survival in Colon Cancer

Se Woo Park,Hang Lak Lee,Kang Hong Lee,Kang Nyeong Lee,Eun Young Doo,Dae Won Jun,Oh Young Lee,Dong Soo Han,Byung Chul Yoon,Ho Soon Choi

doi:10.1007/s11605-015-2834-z

Abstract

BackgroundThe relationship between visceral obesity and colon cancer outcome has not been well studied. The goal of this study was to determine the impact of visceral obesity on lymph node (LN) metastasis and overall survival (OS) in colon cancer. Materials and MethodsMetastatic LN ratio (MLR) was defined as the number of involved nodes by tumor divided by the total number of resected LNs. Visceral (VFA) and subcutaneous fat areas (SFA) were determined by measuring abdominal fat volume distribution via CT scan, and visceral obesity was defined as a VFA to total fat area ratio (V/T) > 0.29. ResultsIn a multivariate analysis among 186 patients, there were inverse associations between V/T and MLR (OR = 0.413, 95 % CI = 0.216–0.789, P = 0.007). Furthermore, patients with visceral obesity tended to have significantly better OS than patients with non-visceral obesity. ConclusionsHigher V/T ratios which indicate referring to visceral obesity was significantly associated with decreased MLR and better OS for CRC.

Highlights

Obesity is an even more prevalent issue in the world, but comparable data on associations with cancer are lacking.[1]
J Gastrointest Surg (2015) 19:1513–1521 greater duration of hospital stay. Another study[7] evaluated the importance of lymph node (LN) metastasis in colon cancer found that visceral obesity was associated with a lower likelihood of metastatic LN involvement because excess fat may limit accessibility to LNs located deep in the adipose tissue around major abdominal vessels not included in the routine en bloc resection
In 186 patients with colon cancer, fat measurement was evaluated with preoperative multi-detector computed tomography (MDCT) and these patients were included in the study

Summary

Introduction

Obesity is an even more prevalent issue in the world, but comparable data on associations with cancer are lacking.[1]. Another study[7] evaluated the importance of LN metastasis in colon cancer found that visceral obesity was associated with a lower likelihood of metastatic LN involvement because excess fat may limit accessibility to LNs located deep in the adipose tissue around major abdominal vessels not included in the routine en bloc resection. Materials and Methods Metastatic LN ratio (MLR) was defined as the number of involved nodes by tumor divided by the total number of resected LNs. Visceral (VFA) and subcutaneous fat areas (SFA) were determined by measuring abdominal fat volume distribution via CT scan, and visceral obesity was defined as a VFA to total fat area ratio (V/T)>0.29. Conclusions Higher V/T ratios which indicate referring to visceral obesity was significantly associated with decreased MLR and better OS for CRC

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Discussion

Conclusion