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Inverse Association Between Visceral Obesity and Lymph Node Metastasis in Gastric Cancer

Abstract

Background

The relationship between fat distribution and lymph node metastasis has not been well studied. The goal of this study was to determine the impact of visceral obesity on lymph node metastasis in gastric cancer.

Materials and Methods

Metastatic lymph node ratio (MLR) was defined as the number of involved nodes by tumor divided by the total number of resected lymph nodes. 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.

Results

With lymph node metastasis as a dependent variable, the following factors were significant in multivariate analysis among 495 patients: pathologic T stage (P < 0.001), lympho-vascular invasion (P < 0.001), and V/T (hazard ratio (HR) = 0.455, 95 % confidence interval (CI) = 0.263–0.786, P = 0.005). Similarly, when MLR was the dependent variable in multivariate analysis, MLR was significantly associated with lympho-vascular invasion (HR = 2.222, 95 % CI = 1.149–4.296, P = 0.018), and V/T (HR = 0.247, 95 % CI = 0.133–0.458, P < 0.001).

Conclusions

Visceral obesity defined by higher visceral to total fat area ratio was significantly associated with decreased MLR.

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Author Contributions

Hang Lak Lee and Se Woo Park were responsible for the study conception and design. Se Woo Park and Eun Young Doo contributed to the acquisition of data. Se Woo Park and Hang Lak Lee did the analysis and interpretation of data. Se Woo Park, Dae Won Jun, Oh Young Lee, Dong Soo Han, Byung Chul Yoon, Ho Soon Choi, and Joon Soo Hahm contributed to the drafting of the manuscript. Se Woo Park and Hang Lak Lee revised the manuscript. Hang Lak Lee and Se Woo Park supervised the study and did the final approval.

Conflict of Interest

The authors have no potential conflicts of interest. The authors alone are responsible for the content and writing of the paper.

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Correspondence to Hang Lak Lee.

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Park, S.W., Lee, H.L., Ju, Y.W. et al. Inverse Association Between Visceral Obesity and Lymph Node Metastasis in Gastric Cancer. J Gastrointest Surg 19, 242–250 (2015). https://doi.org/10.1007/s11605-014-2682-2

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  • DOI: https://doi.org/10.1007/s11605-014-2682-2

Keywords

  • Obesity
  • Visceral fat area
  • Lymph node
  • Metastasis
  • Gastric cancer