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Obesity was associated with a decreased postoperative recurrence of rectal cancer in a Japanese population

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Abstract

Purpose

Obesity contributes to the technical difficulty of rectal surgery and is considered to be a risk factor for postoperative complications. The impact of obesity on the long-term outcomes of rectal cancer surgery remains unclear.

Methods

A total of 263 consecutive rectal cancer patients who underwent surgery were categorized into two groups according to the body mass index (BMI) based on the Asian BMI classification: non-obese (BMI <25 kg/m2) and obese (BMI ≥25 kg/m2). The postoperative survival and recurrence rates and oncological surgical quality indicators were compared between groups using the univariate and multivariate analyses. The differences in recurrence patterns were assessed by a competing risk regression analysis.

Results

64 (24 %) patients were included in the obese group. The number of retrieved lymph nodes was significantly greater in the non-obese group than in the obese group (22.4 vs. 16.0, P < 0.01). The 5-year disease-free survival (DFS) rates were 86.5 and 68.8 % in the obese and non-obese groups, respectively (P = 0.01). The multivariate analysis demonstrated that obesity significantly decreased the postoperative recurrence rate (P = 0.04). Moreover, the BMI was significantly associated with distant metastasis (P = 0.04).

Conclusions

Obese rectal cancer patients have high DFS rates and a decreased incidence of distant metastases compared to non-obese patients. The BMI may be a key factor for predicting the postoperative prognosis and determination of an appropriate strategy for the treatment of rectal cancer patients.

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Conflict of interest

The authors declare no conflicts of interest.

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Authors and Affiliations

  1. Department of Surgery, Keio University School of Medicine, 35 Shinano-machi, Shinjuku-ku, Tokyo, 1608582, Japan

    Ryo Seishima, Koji Okabayashi, Hirotoshi Hasegawa, Yoshiyuki Ishii, Masashi Tsuruta & Yuko Kitagawa

  2. Department of Preventive Medicine and Public Health, Keio University School of Medicine, 35 Shinano-machi, Shinjuku-ku, Tokyo, Japan

    Daisuke Sugiyama & Toru Takebayashi

Authors
  1. Ryo Seishima
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  2. Koji Okabayashi
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  3. Hirotoshi Hasegawa
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  4. Daisuke Sugiyama
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  5. Yoshiyuki Ishii
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  6. Masashi Tsuruta
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  7. Toru Takebayashi
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  8. Yuko Kitagawa
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Correspondence to Hirotoshi Hasegawa.

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Seishima, R., Okabayashi, K., Hasegawa, H. et al. Obesity was associated with a decreased postoperative recurrence of rectal cancer in a Japanese population. Surg Today 44, 2324–2331 (2014). https://doi.org/10.1007/s00595-014-0899-z

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  • DOI: https://doi.org/10.1007/s00595-014-0899-z

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