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Quantitative Assessment of Visceral Obesity and Postoperative Colon Cancer Outcomes

Journal of Gastrointestinal Surgery volume 21, pages 534–542 (2017)Cite this article

Abstract

Background

Quantitative computed tomography (CT) assessment of visceral adiposity may be superior to body mass index (BMI) as a predictor of surgical morbidity. We sought to examine the association of CT measures of obesity and BMI with short-term postoperative outcomes in colon cancer patients.

Methods

In this retrospective study, 110 patients treated with colectomy for stage I–III colon cancer were classified as obese or non-obese by preoperative CT-based measures of adiposity or BMI [obese: BMI ≥ 30 kg/m2, visceral fat area (VFA) to subcutaneous fat area ratio (V/S) ≥0.4, and VFA > 100 cm2]. Postoperative morbidity and mortality rates were compared.

Results

Obese patients, by V/S and VFA but not BMI, were more likely to be male and have preexisting hypertension and diabetes. The overall complication rate was 25.5%, and there were no mortalities. Obese patients by VFA (with a trend for V/S but not BMI) were more likely to develop postoperative complications as compared to patients classified as non-obese: VFA (30.5 vs.10.7%, p = 0.03), V/S (29.2 vs. 9.5%, p = 0.05), and BMI (32.4 vs. 21.9%, p = 0.23).

Conclusions

Elevated visceral obesity quantified by CT is associated with the presence of key metabolic comorbidities and increased postoperative morbidity and may be superior to BMI for risk stratification.

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Acknowledgements

The authors thank Jaime Corvin, PhD, and Nnadozie Emechebe, BPharm, MPH, for reviewing certain aspects of the study.

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Author notes

    Affiliations

    1. Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, FL, USA

      Oluwatobi O. Ozoya, Erin M. Siegel, Thejal Srikumar, Amanda M. Bloomer & Amanda DeRenzis

    2. Department of Global Health, College of Public Health, University of South Florida, Tampa, FL, USA

      Oluwatobi O. Ozoya

    3. Health Research Informatics, Moffitt Cancer Center, Tampa, FL, USA

      Erin M. Siegel

    4. Morsani College of Medicine, University of South Florida, Tampa, FL, USA

      Thejal Srikumar

    5. Department of Surgery, University of Tennessee Health Science Center, 910 Madison Avenue, Room 203, Memphis, TN, 38163, USA

      David Shibata

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    1. Oluwatobi O. Ozoya
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    Corresponding author

    Correspondence to David Shibata.

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    Grant Support

    This work was supported in part by the Moffitt Cancer Center TJS Colorectal Cancer Research Fund and the Bankhead Coley New Investigator Grant (09BN-13).

    Author Contributions

    Substantial contributions to conception and design, or acquisition of data, or analysis and interpretation of data: OO, ES, DS, TS, AB, AD

    Drafting the article or revising it critically for important intellectual content: DS, ES, OO, AB, TS, AD

    Final approval of the version to be published: DS, ES, OO, AB, TS, AD

    Agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved: ES, DS, OO, AB,TS, AD

    Additional information

    Oluwatobi O. Ozoya and Erin M. Siegel contributed equally to this work.

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    Ozoya, O.O., Siegel, E.M., Srikumar, T. et al. Quantitative Assessment of Visceral Obesity and Postoperative Colon Cancer Outcomes. J Gastrointest Surg 21, 534–542 (2017). https://doi.org/10.1007/s11605-017-3362-9

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    • DOI: https://doi.org/10.1007/s11605-017-3362-9

    Keywords

    • Computed tomography
    • Visceral obesity
    • Colon cancer
    • Surgical complication