J Minim Invasive Surg.  2016 Dec;19(4):148-155. 10.7602/jmis.2016.19.4.148.

Long-term Oncologic Outcomes of Obesity after Laparoscopic Surgery for Colorectal Cancer in Asian Patients

• Kwak JH
• Park JW
• Park BK
• Han EC
• Kim JK
• Kwon YH
• Ryoo SB
• Jeong SY
• Park KJ

• KMID: 2362231
• DOI: http://doi.org/10.7602/jmis.2016.19.4.148

Abstract

PURPOSE
The adverse effects of obesity on short-term surgical outcomes after laparoscopic colorectal surgery have been reported. However, the influence of obesity on long-term oncological outcomes after laparoscopic surgery in Asian patients has not been well understood. The aim of this study was to evaluate the effect of obesity on long-term oncologic outcomes in patients who underwent laparoscopic surgery for colorectal cancer.
METHODS
Overall, 424 consecutive patients who underwent laparoscopic resection for colorectal cancer between January 2005 and July 2012 were included in this retrospective study. Patients were classified as non-obese (body mass index [BMI] <25.0 kg/m²) and obese (BMI ≥25.0 kg/m²) according to the categories proposed by the International Obesity Task Force. A survival analysis was performed using clinicopathologic characteristics, including obesity.
RESULTS
Of the 424 patients, 325 (76.7%) were classified as non-obese and 99 (23.3%) as obese. The clinicopathologic characteristics of the obese and non-obese groups were similar, except that there were more underlying comorbidities, a lower frequency of smoking, and fewer tumors in rectum in the obese group. Results of the multivariate analysis showed that older age, elevated serum carcinoembryonic antigen, high-grade histology, advanced tumor stage, and perineural invasion were associated with poorer disease-free survival and overall survival. Obesity was not significantly associated with disease-free survival (hazard ratio [HR], 1.196; 95% confidence interval [CI], 0.686~2.086; p=0.528) or overall survival (HR, 1.156; 95% CI, 0.584~2.289; p=0.677).
CONCLUSION
Laparoscopic surgery for colorectal cancer seems to be safe and feasible for obese patients in terms of long-term oncologic outcomes.

Keyword

Obesity; Body mass index; Laparoscopic surgery; Colorectal cancer

MeSH Terms

Advisory Committees
Asian Continental Ancestry Group*
Body Mass Index
Carcinoembryonic Antigen
Colorectal Neoplasms*
Colorectal Surgery
Comorbidity
Disease-Free Survival
Humans
Laparoscopy*
Multivariate Analysis
Obesity*
Rectum
Retrospective Studies
Smoke
Smoking
Carcinoembryonic Antigen
Smoke