Visceral obesity is associated with outcomes of total mesorectal excision for rectal adenocarcinoma
Visceral obesity is associated with outcomes of total mesorectal excision for rectal adenocarcinoma
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DOI：
10.1002/jso.22031
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发表时间：
2012-03-01
影响因子：
2.5
通讯作者：
Kennedy, Gregory D.
中科院分区：
文献类型：
--
作者：
Ballian, Nikiforos;Lubner, Meghan G.;Kennedy, Gregory D.
背景和目的：通过体重指数（BMI）衡量的一般性肥胖增加了全直肠系膜切除术（TME）的技术难度，但不影响肿瘤学结果。本研究的目的是比较内脏肥胖和全身肥胖作为直肠腺癌 TME 结局的预测因素。方法：回顾性鉴定接受 TME 治疗直肠腺癌的成年患者。术前计算机断层扫描用于测量腹围（AC）、内脏（VFA）和皮下脂肪面积（SFA）。在单变量分析模型中检查了 BMI、AC、VFA、SFA、总脂肪面积（TFA、VFA 和 SFA 之和）以及 VFA/SFA 比值与手术、术后、肿瘤和生存结果的关系。结果：1999 年至 2009 年间，113 名患者符合纳入标准。 VFA 和 VFA/SFA 比率的增加与淋巴结切除的减少相关（分别为 P = 0.03 和 P = 0.009）。 VFA/SFA 比率增加与延迟恢复口服摄入 (P = 0.05) 和延长总生存期 (P = 0.003) 之间的关联也很显着。 BMI 的增加与总体改善相关 (P = 0.02)，但与无病生存率无关 (P = 0.14)。结论：与通过 BMI 测量的一般肥胖相比，通过 VFA/SFA 比率测量的内脏肥胖是直肠腺癌 TME 术后、肿瘤学和生存结果的更好预测指标。 J.外科医生。安科尔。 2012年； 105：365-370。 (C) 2011 年 Wiley 期刊公司。
Background and Objectives: General obesity, measured by the body mass index (BMI), increases the technical difficulty of total mesorectal excision (TME) but does not affect oncologic outcomes. The purpose of this study is to compare visceral and general obesity as predictors of outcomes of TME for rectal adenocarcinoma.Methods: Adult patients undergoing TME for rectal adenocarcinoma were retrospectively identified. Preoperative computed tomography scans were used to measure abdominal circumference (AC), visceral (VFA), and subcutaneous fat area (SFA). BMI, AC, VFA, SFA, total fat area (TFA, sum of VFA and SFA), and VFA/SFA ratio were examined for association with operative, postoperative, oncologic, and survival outcomes in a univariate analysis model.Results: Between 1999 and 2009, 113 patients met inclusion criteria. Increasing VFA and VFA/SFA ratio were associated with reduced lymph node retrieval ( P = 0.03 and P = 0.009, respectively). The association between increasing VFA/SFA ratio with delayed resumption of oral intake (P = 0.05) and prolonged overall survival (P = 0.003) were also significant. Increasing BMI was associated with improved overall (P = 0.02) but not disease-free survival (P = 0.14).Conclusion: Visceral obesity, measured by VFA/SFA ratio, is a better predictor of postoperative, oncologic, and survival outcomes after TME for rectal adenocarcinoma than general obesity measured by the BMI. J. Surg. Oncol. 2012; 105: 365-370. (C) 2011 Wiley Periodicals, Inc.