Distribution and Impact of the Visceral Fat Area in Patients With Colorectal Cancer

다국어 초록 (Multilingual Abstract)

Purpose: The purposes of this study were to investigate the distribution of the visceral fat area (VFA) and general obesity and to compare visceral and general obesity as predictors of surgical outcomes of a colorectal cancer resection.
Methods: The prospectively collected data of 102 patients with preoperatively-diagnosed sigmoid colon or rectal cancer who had undergone a curative resection at Pusan National University Yangsan Hospital between April 2011 and September 2012 were reviewed retrospectively. Men with a VFA of >130 cm2 and women with a VFA of >90 cm2 were classified as obese (VFA-O, n = 22), and the remaining patients were classified as nonobese (VFA-NO, n = 80).
Results: No differences in morbidity, mortality, postoperative bowel recovery, and readmission rate after surgery were observed between the 2 groups. However, a significantly higher number of harvested lymph nodes was observed in the VFA-NO group compared with the VFA-O group (19.0 ± 1.0 vs. 13.5 ± 1.2, respectively, P = 0.001).
Conclusion: Visceral obesity has no influence on intraoperative difficulties, postoperative complications, and postoperative recovery in patients with sigmoid colon or rectal cancer.

참고문헌 (Reference)

1 Tsujinaka S, "Visceral obesity predicts surgical outcomes after laparoscopic colectomy for sigmoid colon cancer" 51 : 1757-1765, 2008

2 Moon HG, "Visceral obesity may affect oncologic outcome in patients with colorectal cancer" 15 : 1918-1922, 2008

3 Ballian N, "Visceral obesity is associated with outcomes of total mesorectal excision for rectal adenocarcinoma" 105 : 365-370, 2012

4 International Diabetes Institute, "The Asia Pacific perspective: redefining obesity and its treatment"

5 Oka R, "Reassessment of the cutoff values of waist circumference and visceral fat area for identifying Japanese subjects at risk for the metabolic syndrome" 79 : 474-481, 2008

6 Flegal KM, "Prevalence of obesity and trends in the distribution of body mass index among US adults, 1999-2010" 307 : 491-497, 2012

7 Martínez ME, "Physical activity, body mass index, and prostaglandin E2 levels in rectal mucosa" 91 : 950-953, 1999

8 Kunisaki C, "Learning curve for laparoscopy-assisted distal gastrectomy with regional lymph node dissection for early gastric cancer" 18 : 236-241, 2008

9 Despres JP, "Is visceral obesity the cause of the metabolic syndrome?" 38 : 52-63, 2006

10 Pikarsky AJ, "Is obesity a high-risk factor for laparoscopic colorectal surgery?" 16 : 855-858, 2002

11 Gorog D, "Influence of obesity on lymph node recovery from rectal resection specimens" 9 : 180-183, 2003

12 Ishii Y, "Impact of visceral obesity on surgical outcome after laparoscopic surgery for rectal cancer" 92 : 1261-1262, 2005

13 Lohsiriwat V, "Impact of metabolic syndrome on the short-term outcomes of colorectal cancer surgery" 53 : 186-191, 2010

14 Park HS, "Greater beneficial effects of visceral fat reduction compared with subcutaneous fat reduction on parameters of the metabolic syndrome: a study of weight reduction programmes in subjects with visceral and subcutaneous obesity" 22 : 266-272, 2005

15 Seki Y, "Evaluation of the technical difficulty performing laparoscopic resection of a rectosigmoid carcinoma: visceral fat reflects technical difficulty more accurately than body mass index" 21 : 929-934, 2007

16 Grundy SM, "Diagnosis and management of the metabolic syndrome: an American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement" 112 : 2735-2752, 2005

17 Renehan AG, "Body-mass index and incidence of cancer: a systematic review and meta-analysis of prospective observational studies" 371 : 569-578, 2008

18 Kvist H, "Adipose tissue volume determination in males by computed tomography and 40K" 12 : 249-266, 1988

19 Despres JP, "Abdominal obesity and metabolic syndrome" 444 : 881-887, 2006

20 Yoshizumi T, "Abdominal fat: standardized technique for measurement at CT" 211 : 283-286, 1999

21 Wang Y, "A prospective study of waist circumference and body mass index in relation to colorectal cancer incidence" 19 : 783-792, 2008

22 Tokunaga K, "A novel technique for the determination of body fat by computed tomography" 7 : 437-445, 1983