The Obesity Paradox in Colorectal Cancer Surgery: An Analysis of Korean Healthcare Big Data, 2012-2013
The Obesity Paradox in Colorectal Cancer Surgery: An Analysis of Korean Healthcare Big Data, 2012-2013
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DOI：
10.1080/01635581.2017.1263744
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发表时间：
2017-01-01
影响因子：
2.9
通讯作者：
Lee, Sanghun
中科院分区：
文献类型：
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作者：
Lee, Sanghun
虽然众所周知，肥胖会增加结直肠癌的风险，但最近的几项研究表明，超重或一级肥胖的人在手术后有更好的结果。然而，肥胖对结直肠癌手术成功的影响仍然存在争议。方法回顾性分析2012 - 2013年经手术治疗的结直肠癌患者的病历资料。韩国健康保险审查与评估服务的医疗保健大数据中心提供了总计36，740名患者的数据。多因素分析显示，住院时间（LOS）与年龄、癌症分期和体重指数显著相关。超重组和一级肥胖组住院时间超过2周与正常体重组相比的优势比为0.903（95%置信区间，0.866 - 0.941）和0.887（95%可信区间，0.851-0.924），而体重不足组为1.280（95%可信区间，1.202-1.362）。肥胖悖论适用于结直肠癌，如超重和肥胖患者的医院LOS减少所示。这一结果表明，肥胖患者的营养状况具有保护作用，有助于结直肠癌手术的恢复。
Although it is well known that obesity increases the risk of colorectal cancer, several studies have recently suggested that those who are overweight or class-one obese have better outcomes after surgery. However, the impact of obesity on the success of colorectal cancer surgery remains controversial. The medical records of patients diagnosed with colorectal cancer who were treated surgically from 2012 through 2013 were retrospectively analyzed. Data from a total of 36,740 patients were provided by the Healthcare Big Data Hub of the Korean Health Insurance Review & Assessment Service. Multivariate analyses suggested that hospital length of stay (LOS) was significantly associated with age, cancer stage, and body mass index. The odds ratios of spending more than 2weeks in the hospital for the overweight or class-one obese groups compared to the normal weight group were 0.903 (95% confidence interval, 0.866-0.941) and 0.887 (95% confidence interval, 0.851-0.924), respectively, while that of the underweight group was 1.280 (95% confidence interval, 1.202-1.362). The obesity paradox applies to colorectal cancer, as indicated by decreased hospital LOS of overweight and obese patients. This result suggests that there is a protective effect of nutritional status in obese patients, which contributes to recovery from colorectal cancer surgery.