Londero Francesco, Parise Orlando, Grossi William, Morelli Angelo, Masullo Gianluca, Bartoletti Michele, Tetta Cecilia, Livi Ugolino, Maessen Jos G, Gelsomino Sandro
Department of Cardiothoracic Surgery, S. Maria della Misericordia University Hospital, 33100 Udine, Italy.
Cardiovascular Research Institute, Maastricht University, 6229HX Maastricht, The Netherlands.
J Clin Med. 2020 Nov 5;9(11):3566. doi: 10.3390/jcm9113566.
Obesity correlates with better outcomes in many neoplastic conditions. The aim of this study was to assess its role in the prognosis and morbidity of patients submitted to resection of lung oligometastases from colorectal cancer. Seventy-six patients undergoing a first pulmonary metastasectomy were retrospectively included in the study. Seventeen (22.3%) were obese (body mass index (BMI) >30 kg/m). Assessed outcomes were overall survival, time to recurrence, and incidence of post-operative complications. Median follow-up was 33 months (IQR 16-53). At follow-up, 37 patients (48.6%) died, whereas 39 (51.4%) were alive. A significant difference was found in the 3-year overall survival (obese 80% vs. non-obese 56.8%, = 0.035). Competing risk analysis shows that the cumulative incidence of recurrence was not different between the two groups. Multivariate analysis reveals that the number of metastases ( = 0.028), post-operative pneumonia ( = 0.042), and DFS ( = 0.007) were significant predictors of death. Competing risk regression shows that no independent risk factor for recurrence has been identified. The complication rate was not different between the two groups (17.6% vs. 13.6%, = 0.70). Obesity is a positive prognostic factor for survival after pulmonary metastasectomy for colorectal cancer. Overweight patients do not experience more post-operative complications. Our results need to be confirmed by large multicenter studies.
肥胖与许多肿瘤性疾病的较好预后相关。本研究的目的是评估其在接受结直肠癌肺寡转移灶切除患者的预后和发病情况中的作用。本研究回顾性纳入了76例首次接受肺转移瘤切除术的患者。其中17例(22.3%)为肥胖患者(体重指数(BMI)>30kg/m²)。评估的结局指标为总生存期、复发时间和术后并发症发生率。中位随访时间为33个月(四分位间距16 - 53个月)。随访时,37例患者(48.6%)死亡,39例(51.4%)存活。3年总生存期存在显著差异(肥胖患者为80%,非肥胖患者为56.8%,P = 0.035)。竞争风险分析显示,两组之间复发的累积发生率无差异。多因素分析显示,转移灶数量(P = 0.028)、术后肺炎(P = 0.042)和无病生存期(P = 0.007)是死亡的显著预测因素。竞争风险回归显示,未发现复发的独立危险因素。两组之间的并发症发生率无差异(17.6%对13.6%,P = 0.70)。肥胖是结直肠癌肺转移瘤切除术后生存的一个积极预后因素。超重患者术后并发症并未增多。我们的结果需要大型多中心研究加以证实。