Published in:
01-12-2014 | Original Article
Obesity was associated with a decreased postoperative recurrence of rectal cancer in a Japanese population
Authors:
Ryo Seishima, Koji Okabayashi, Hirotoshi Hasegawa, Daisuke Sugiyama, Yoshiyuki Ishii, Masashi Tsuruta, Toru Takebayashi, Yuko Kitagawa
Published in:
Surgery Today
|
Issue 12/2014
Login to get access
Abstract
Purpose
Obesity contributes to the technical difficulty of rectal surgery and is considered to be a risk factor for postoperative complications. The impact of obesity on the long-term outcomes of rectal cancer surgery remains unclear.
Methods
A total of 263 consecutive rectal cancer patients who underwent surgery were categorized into two groups according to the body mass index (BMI) based on the Asian BMI classification: non-obese (BMI <25 kg/m2) and obese (BMI ≥25 kg/m2). The postoperative survival and recurrence rates and oncological surgical quality indicators were compared between groups using the univariate and multivariate analyses. The differences in recurrence patterns were assessed by a competing risk regression analysis.
Results
64 (24 %) patients were included in the obese group. The number of retrieved lymph nodes was significantly greater in the non-obese group than in the obese group (22.4 vs. 16.0, P < 0.01). The 5-year disease-free survival (DFS) rates were 86.5 and 68.8 % in the obese and non-obese groups, respectively (P = 0.01). The multivariate analysis demonstrated that obesity significantly decreased the postoperative recurrence rate (P = 0.04). Moreover, the BMI was significantly associated with distant metastasis (P = 0.04).
Conclusions
Obese rectal cancer patients have high DFS rates and a decreased incidence of distant metastases compared to non-obese patients. The BMI may be a key factor for predicting the postoperative prognosis and determination of an appropriate strategy for the treatment of rectal cancer patients.