J Clin Nutr.  2021 Jun;13(1):17-23. 10.15747/jcn.2021.13.1.17.

Impact of Visceral Fat Area Measured by Bioelectrical Impedance Analysis on Clinico-Pathologic Outcomes of Colorectal Surgery

• Kim KE
• Song WJ
• Seok M
• Bae SU
• Jeong WK
• Baek SK

• KMID: 2518320
• DOI: http://doi.org/10.15747/jcn.2021.13.1.17

Abstract

Purpose
This study investigated the relationship between the visceral fat area (VFA) and clinico-pathological outcomes in patients with colorectal cancer (CRC).
Methods
This retrospective study included 204 patients who underwent anthropometric measurement by bioelectrical impedance analysis (BIA) before surgical treatment for CRC between January 2016 and June 2020.
Results
According to the average value of the visceral fat area, 119 (58.3%) patients had a low visceral fat area, and 85 (59.1%) patients had a high visceral fat area. Patients with visceral obesity showed a higher BMI compared to patients without visceral obesity, (21.8±1.9 vs. 25.7±2.5, P＜0.001). There was no significant difference in the overall perioperative outcomes including total operation time, time to gas out, sips of water, soft diet, hospital stay, and morbidity between patients in the low and high VFA groups. We divided patients into two subgroups according to the degree of cancer progression and more advanced cases with low VFA showed significantly more total and positive retrieved lymph nodes (LNs) (20.9±10.3 vs. 16.1±7.1, P=0.021 and 3.3±2.9 vs. 2.2±2.3, P=0.019, respectively) and a higher proportion of more than 12 retrieved LNs compared to patients with a high VFA (95.1% vs. 90.0%, P=0.047). Body composition analysis showed that phase angle, muscle composition, and body fluid composition were not statistically different between the two groups. However, body fat mass was statistically higher in the high VFA group (22.0±4.6 vs. 12.8±3.1, P＜0.001).
Conclusion
Visceral obesity measured by BIA showed lower total and positive retrieved LNs and was not associated with adverse peri-operative outcomes, inflammatory and nutritional, and pathologic outcomes for CRC.

Keyword

Colorectal neoplasm; Nutrition assessment; Body composition; Electric impedance; Prognosis