Yamamoto Naoto, Fujii Shoichi, Sato Tsutomu, Oshima Takashi, Rino Yasushi, Kunisaki Chikara, Masuda Munetaka, Imada Toshio
Department of Gastrointestinal Surgery, Kanagawa Cancer Center, Kanagawa-ken 241-0815, Japan.
Asia Pac J Clin Oncol. 2012 Dec;8(4):337-45. doi: 10.1111/j.1743-7563.2011.01512.x. Epub 2012 Mar 12.
Obesity and visceral obesity are closely related to the development of colorectal cancer, as well as other metabolic complications. We investigated the prognostic significance of body mass index (BMI) and visceral obesity in 273 patients with resectable colorectal cancer.
Visceral fat area (VFA) and subcutaneous fat area were measured on digital images of patients' computed tomograms obtained before surgery. The patients were divided into two groups according to the cut-off levels of VFA proposed by Oka et al. Men with a VFA of ≥130 cm(2) and women with a VFA of ≥90 cm(2) were classified as obese (VFA-obese) and the others were classified as non-obese (VFA-non-obese). The patients were also divided into an overweight group and a normal range group, according to their preoperative BMI.
There was no significant difference in cumulative recurrence-free survival (RFS) or overall survival (OS) between the VFA-obese group and the VFA-non-obese group. In the subgroup of patients with Dukes' C disease (n = 100) there was no statistically significant difference in RFS and OS between the VFA-obese group and the VFA-non-obese group. The results were similar when the patients were classified according to their BMI.
Neither obesity nor increased visceral adiposity has any influence on outcomes in patients with resectable colorectal cancer.
肥胖及内脏型肥胖与结直肠癌的发生以及其他代谢并发症密切相关。我们调查了273例可切除结直肠癌患者的体重指数（BMI）和内脏型肥胖的预后意义。
在术前获取的患者计算机断层扫描数字图像上测量内脏脂肪面积（VFA）和皮下脂肪面积。根据Oka等人提出的VFA临界值将患者分为两组。VFA≥130 cm²的男性和VFA≥90 cm²的女性被归类为肥胖（VFA肥胖），其他患者被归类为非肥胖（VFA非肥胖）。根据患者术前BMI，还将其分为超重组和正常范围组。
VFA肥胖组和VFA非肥胖组之间的累积无复发生存期（RFS）或总生存期（OS）无显著差异。在Dukes' C期疾病患者亚组（n = 100）中，VFA肥胖组和VFA非肥胖组之间的RFS和OS无统计学显著差异。根据BMI对患者进行分类时，结果相似。
肥胖和内脏脂肪增多对可切除结直肠癌患者的预后均无影响。
