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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 12/2015

01-11-2015 | Gastrointestinal Oncology

Low Visceral Fat Content is Associated with Poor Prognosis in a Database of 507 Upper Gastrointestinal Cancers

Authors: Kazuto Harada, MD, Yoshifumi Baba, MD, PhD, FACS, Takatsugu Ishimoto, MD, PhD, Keisuke Kosumi, MD, Ryuma Tokunaga, MD, Daisuke Izumi, MD, Satoshi Ida, MD, PhD, Yu Imamura, MD, PhD, Shiro Iwagami, MD, PhD, FACS, Yuji Miyamoto, MD, PhD, FACS, Yasuo Sakamoto, MD, PhD, FACS, Naoya Yoshida, MD, PhD, FACS, Masayuki Watanabe, MD, PhD, FACS, Hideo Baba, MD, PhD, FACS

Published in: Annals of Surgical Oncology | Issue 12/2015

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Abstract

Background

Excess visceral adipose tissue may promote cancer development and progression via an obesity-related metabolic derangements, including adipocytokine-related inflammation, insulin resistance, and hypoxia. The relationship between visceral fat content and patient prognosis has been reported in some types of cancers, but not in the upper gastrointestinal cancer. The purpose of this retrospective study was to investigate the relationship between visceral fat status and clinical outcome in patients with upper gastrointestinal cancers (esophageal cancer and gastric cancer) treated by surgical resection.

Methods

This retrospective study was conducted in a single, academic hospital in Kumamoto, Japan, and involved 507 patients with upper gastrointestinal cancers between April 2005 and December 2010. Preoperative visceral fat content was quantified by radiologic measures using standard computed tomography scans.

Results

Higher visceral fat mount was correlated with male sex, presence of preoperative comorbidity, absence of preoperative therapy, low tumor depth, low tumor stage, and gastric cancer. Compared to high visceral fat cases, low visceral fat cases experienced a higher overall mortality rate [log-rank p = 0.0050; univariate hazard ratio (HR) = 1.73, 95 % confidence interval (CI) 1.16–2.54; p = 0.0075; multivariate HR 1.57; 95 % CI 1.02–2.37; p = 0.031]. Interestingly, the influence of low visceral fat on patient outcome was modified by age at surgery (p for interaction = 0.036); low visceral fat was associated with a poor prognosis, especially in elderly patients (log-rank p < 0.0001).

Conclusion

Visceral fat content in the upper gastrointestinal cancers was associated with a poor prognosis, thus suggesting that it has potential for use as a prognostic biomarker.
Appendix
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Metadata
Title
Low Visceral Fat Content is Associated with Poor Prognosis in a Database of 507 Upper Gastrointestinal Cancers
Authors
Kazuto Harada, MD
Yoshifumi Baba, MD, PhD, FACS
Takatsugu Ishimoto, MD, PhD
Keisuke Kosumi, MD
Ryuma Tokunaga, MD
Daisuke Izumi, MD
Satoshi Ida, MD, PhD
Yu Imamura, MD, PhD
Shiro Iwagami, MD, PhD, FACS
Yuji Miyamoto, MD, PhD, FACS
Yasuo Sakamoto, MD, PhD, FACS
Naoya Yoshida, MD, PhD, FACS
Masayuki Watanabe, MD, PhD, FACS
Hideo Baba, MD, PhD, FACS
Publication date
01-11-2015
Publisher
Springer US
Published in
Annals of Surgical Oncology / Issue 12/2015
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-015-4432-4

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