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Published in: International Journal of Colorectal Disease 11/2010

01-11-2010 | Original Article

Impact of obesity on surgical and oncological outcomes in the management of colorectal cancer

Authors: Laura A. Healy, Aoife M. Ryan, Ellis Sutton, Katherine Younger, Brain Mehigan, Richard Stephens, John V. Reynolds

Published in: International Journal of Colorectal Disease | Issue 11/2010

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Abstract

Introduction

Obesity is an established risk factor for colorectal cancer, particularly in males, and may negatively impact on oncologic outcomes. The aim of this study was to examine the impact of body mass index (BMI) on mortality and morbidity, tumour pathology, and overall survival in a consecutive cohort of Irish colorectal cancer patients treated with curative intent.

Methods

A retrospective analysis of BMI data entered prospectively into a comprehensive electronic database of colorectal cancer patients was undertaken. Patients were excluded if they had emergency surgery, previous malignancy or the BMI was not recorded. Analysis was performed comparing genders, obese with non-obese and comparing BMI categories.

Results

Of the 414 patients, 10% were underweight (<20 kg/m2); 35% were normal weight (20–25 kg/m2); 37% were overweight (25–30 kg/m2), and 18% were obese (≥30.00 kg/m2). Obesity overall was not significantly associated with pathological stage (p = 0.099) or positive lymph node status (p = 0.109) or degree of nodal involvement (p = 0.068). Obesity was significantly (p<0.05) associated with more advanced pathological stage, node positivity and degree of nodal involvement in male only and colon cancer only analysis. There was no difference in the overall incidence of major (p = 0.244) and minor complications (p = 0.078) when comparing obese with non-obese, but pelvic abscesses were more common in obese patients (p = 0.037). The underweight cohort had a higher rate of major complications (p = 0.041), sepsis (p = 0.024) and post-operative death (p = 0.006). Survival was equivalent between BMI categories and obese and non-obese groups (p = 0.469).

Conclusion

Obesity was associated with more advanced tumours in males and in colon cancer patients only and with a higher risk of post-operative pelvic abscesses but no significant differences with non-obese cohorts in the main outcome measures of in-hospital mortality, major morbidity and survival. Conversely, the adverse consequences of under-nutrition were highlighted in this study.
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Metadata
Title
Impact of obesity on surgical and oncological outcomes in the management of colorectal cancer
Authors
Laura A. Healy
Aoife M. Ryan
Ellis Sutton
Katherine Younger
Brain Mehigan
Richard Stephens
John V. Reynolds
Publication date
01-11-2010
Publisher
Springer-Verlag
Published in
International Journal of Colorectal Disease / Issue 11/2010
Print ISSN: 0179-1958
Electronic ISSN: 1432-1262
DOI
https://doi.org/10.1007/s00384-010-0963-0

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