Effects of body composition profiles on oncological outcomes and postoperative intraabdominal infection following colorectal cancer surgery

医学 结直肠癌 体质指数 脂肪组织 外科 前瞻性队列研究 内科学 队列 人体测量学 风险因素 癌症 肿瘤科
作者
T. Perrin,Marc Lenfant,Cyrile Boisson,M. Bert,Patrick Rat,Olivier Facy
出处
期刊:Surgery for Obesity and Related Diseases [Elsevier BV]
卷期号:17 (3): 575-584 被引量:8
标识
DOI:10.1016/j.soard.2020.10.022
摘要

Background Anthropometric data as prognostic factors of colorectal cancer are promising but contradictory. The aim of this study was to assess the preoperative body composition profiles as predictive factors for postoperative, oncologic, and inflammation outcomes. Objectives We sought to assess the impact of body composition profiles on short- and long-term outcomes and on postoperative inflammatory response in a clinical setting for patients following curative intent surgery for colorectal cancer. Setting University hopsital Methods We analyzed 122 patients from a prospective cohort (IMACORS) with colorectal cancer undergoing curative-intent surgery from 2011 to 2014. Musculature, total, visceral, and subcutaneous adiposity were measured from a preoperative CT scan and outcomes were compared between profiles. Results Preoperative myopenia was an independent predictive factor of recurrence (HR = 3.3 95% CI = 1.6–6.9; P = .002) while subcutaneous adiposity was a protective factor (HR = .4 95% CI = .2–.9; P = .03). No anthropometric measurement was predictive of overall survival and postoperative intra abdominal infection was not determined by body composition profiles. Preoperative and D4 CRP levels were significantly higher in patients with subcutaneous adiposity. Conclusions Myopenia and subcutaneous adiposity seemed to have independent and opposite prognostic effects on recurrence. Muscle mass loss may represent a modifiable risk factor while the amount of subcutaneous adipose tissue reflects an energetic storage favorable to face this pathologic process.

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