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Impact of visceral fat on surgical complications and long-term survival of patients with gastric cancer after radical gastrectomy

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Abstract

Background/objectives

The aim of this study was to examine the impact of visceral fat on surgical complications and long-term survival for patients undergoing radical gastrectomy.

Subjects/methods

From 2009 to 2013, 859 patients who underwent curative resection for gastric cancer were enrolled from a prospectively maintained database. Visceral fat area (VFA) was assessed by preoperative CT scans. Patients were divided into two groups by VFA. Perioperative variables and postoperative outcomes were compared between the high VFA group and low VFA group. Univariable and multivariable analysis were performed to investigate independent risk factors of postoperative complications and survival.

Results

Some 859 patients were included in the study, 308 of whom were classified as high VFA. High VFA was correlated with advance age (P = 0.020), higher albumin levels (P = 0.001), hemoglobin levels (P < 0.05), ASA grade (P = 0.043) and Charlson Comorbidity Index (P = 0.004). Relative to patients with low VFA, those with high VFA had longer surgical durations (P = 0.004), higher rate of postoperative complications (P = 0.004), and longer hospital stays (P = 0.004). High VFA was identified as the only determinant for surgical complications by logistic regression analysis (OR, 2.236, 95% CI, 1.537–3.254; P < 0.001). Cox proportional hazards regression revealed no correlation between VFA and overall survival (OS) or disease-free survival (DFS).

Conclusions

Increased VFA independently predicts surgical complications in patients after gastrectomy. However, VFA is not a prognostic biomarker of OS or DFS in patients with gastric cancer.

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Acknowledgements

This work was supported by the foundation of the Health Department of Shanghai (20124017), the Shanghai Science and Technology Committee (16411954200) and the foundation of the Health Department of Zhejiang province (2016139771). The funders had no role in the design, analysis or writing of this article.

Author contributions

C-LZ and XS designed the study. L-LM and X-YC collected the data. BL, D-LZ, D-DH, and ZY did the analysis and interpretation of data. S-LW wrote the article. C-LZ revised the article and took the decision to submit the article for publication.

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    Authors and Affiliations

    1. Department of Gastrointestinal Surgery, the First Affiliated Hospital, Wenzhou Medical University, Wenzhou, China

      Su-Lin Wang, Liang-Liang Ma, Xi-Yi Chen & Cheng-Le Zhuang

    2. Department of Gastrointestinal Surgery, Shanghai Tenth People’s Hospital Affiliated to Tongji University, Shanghai, China

      Dong-Lei Zhou, Dong-Dong Huang, Zhen Yu & Cheng-Le Zhuang

    3. Department of Endocrinology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China

      Bo Li

    4. Department of Gastrointestinal Surgery, the Second Affiliated Hospital, Wenzhou Medical University, Wenzhou, China

      Xian Shen

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    Su-Lin Wang and Liang-Liang Ma have contributed equally to this work.

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    Wang, SL., Ma, LL., Chen, XY. et al. Impact of visceral fat on surgical complications and long-term survival of patients with gastric cancer after radical gastrectomy. Eur J Clin Nutr 72, 436–445 (2018). https://doi.org/10.1038/s41430-017-0032-7

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