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Visceral Fat Area (VFA) Superior to BMI for Predicting Postoperative Complications After Radical Gastrectomy: a Prospective Cohort Study

  • Original Article
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Journal of Gastrointestinal Surgery

Abstract

Background

Obesity may impact surgical outcomes of gastrectomy. Whether visceral fat area (VFA) is a better obesity parameter than body mass index (BMI) is still controversial. The aim of this study is to compare the accuracy and effectiveness of VFA and BMI in predicting the short-term surgical outcomes of gastrectomy.

Methods

Patients who were diagnosed with gastric cancer were measured for BMI and VFA preoperatively and then divided into a VFA-H (VFA-high) group and VFA-L (VFA-low) group, at the cutoff point of 100 cm2, and a BMI-H (BMI-high) group and BMI-L (BMI-low) group, at the cutoff point of 25 kg/m2. The short-term surgical outcomes were compared between the different groups.

Results

In total, 276 patients were enrolled in this study; 55 (19.9%) patients were classified into the BMI-H group, and 122 (44.2%) patients were classified into the VFA-H group. There was a significant correlation between BMI and VFA (r = 0.652, p < 0.001). Compared with the VFA-L group, the VFA-H group had a higher incidence of postoperative complications (31.1% vs. 13.0%; p < 0.001), longer operation duration (270.0 (235.0–305.0) vs. 255.0 (223.8–295.0), p = 0.046), and more blood loss (100.0 (100.0–150.0) vs. 80.0 (80.0–100.0), p < 0.001), while the BMI-H group had more blood loss than the BMI-L group (100.0 (100.0–120.0) vs. 100.0(80.0–100.0), p = 0.006). Logistic regression showed that VFA was an independent risk factor for postoperative complications (odds ratio 2.813, 95% CI 1.523–5.194; p = 0.001).

Conclusion

For gastric cancer patients, VFA is superior to BMI in accurately and effectively illuminating the impact of obesity on short-term surgical outcomes.

Trial Registration

Clinicaltrials.gov: NCT02800005.

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Acknowledgments

The authors thank the valuable work of the Volunteer Team of Gastric Cancer Surgery (VOLTGA) West China Hospital, Sichuan University, China, for the establishment and updating of the gastric cancer database.

Funding

This study is supported by grants of National Natural Science Foundation of China, No.81301866; Sichuan Province Youth Science Technology Innovative Research Team, No.2015TD0009; 1.3.5 project for disciplines of excellence, West China Hospital, Sichuan University (ZY2017304); Fund for Fostering Academic and Technical Leaders of Sichuan Province, No. [2017]919; and Foundation of Science & Technology Department of Sichuan Province (No. 2018SZ0147).

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Author notes

  1. Shijie Yang and Haoran Li contributed equally to this work.

Authors and Affiliations

  1. Department of Gastrointestinal Surgery and Laboratory of Gastric Cancer, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, and Collaborative Innovation Center for Biotherapy, No. 37 Guo Xue Xiang Street, Chengdu, Sichuan Province, China

    Shi-jie Yang, Wei-han Zhang, Kai Liu, Dong-yang Zhang, Li-fei Sun, Xiao-long Chen, Lin-yong Zhao, Xin-zu Chen, Kun Yang, Zhi-xin Chen, Zong-guang Zhou & Jian-kun Hu

  2. West China School of Medicine, Sichuan University, Chengdu, China

    Hao-ran Li

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Yang, Sj., Li, Hr., Zhang, Wh. et al. Visceral Fat Area (VFA) Superior to BMI for Predicting Postoperative Complications After Radical Gastrectomy: a Prospective Cohort Study. J Gastrointest Surg 24, 1298–1306 (2020). https://doi.org/10.1007/s11605-019-04259-0

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