Lee Sanghun
a Department of Medical Consilience , Graduate School, Dankook University , Gyeonggi-do , South Korea.
Nutr Cancer. 2017 Feb-Mar;69(2):248-253. doi: 10.1080/01635581.2017.1263744. Epub 2017 Jan 17.
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 2 weeks 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.
虽然众所周知肥胖会增加患结直肠癌的风险，但最近的几项研究表明，超重或一度肥胖的患者术后预后更好。然而，肥胖对结直肠癌手术成功率的影响仍存在争议。对2012年至2013年接受手术治疗的结直肠癌患者的病历进行了回顾性分析。韩国健康保险审查与评估服务中心的医疗大数据中心提供了总共36740名患者的数据。多变量分析表明，住院时间（LOS）与年龄、癌症分期和体重指数显著相关。与正常体重组相比，超重或一度肥胖组在医院停留超过2周的优势比分别为0.903（95%置信区间，0.866-0.941）和0.887（95%置信区间，0.851-0.924），而体重过轻组的优势比为1.280（95%置信区间，1.202-1.362）。超重和肥胖患者住院时间缩短表明，“肥胖悖论”适用于结直肠癌。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后的康复。
