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Ann Surg Treat Res. 2019 Mar;96(3):116-122. English. Original Article. https://doi.org/10.4174/astr.2019.96.3.116
Lee SY , Kim CH , Kim YJ , Kwak HD , Ju JK , Kim HR .
Department of Surgery, Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Hwasun, Korea. drkhr@chonnam.ac.kr
Department of Surgery, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea.
Abstract

Purpose

The predictive role of obesity on pathologic complete response (pCR) after neoadjuvant chemoradiation (nCRT) in rectal cancer remains controversial. This study aimed to evaluate the association between obesity and pathologic response in patients with rectal cancer following nCRT.

Methods

A total of 320 patients with primary rectal cancer who underwent curative resection after nCRT between January 2010 and September 2014 were enrolled in this study. Obesity was defined as body mass index of ≥25 kg/m². Clinicopathologic characteristics were analyzed to identify independent predictive factors for pCR.

Results

Among the included patients, 23.4% (n = 75) were obese, and 14.7% (n = 47) showed pCR. Baseline characteristics were generally similar between obese and nonobese patients, except that women (P = 0.001) and cT2 tumors (P = 0.001) were more common in the obese group. Multivariate logistic regression analysis revealed that obesity (odds ratio [OR] = 2.051; 95% confidence interval [CI], 1.009–4.168), cT2 (OR, 3.614; 95% CI, 1.166–11.202), and pretreatment carcinoembryonic antigen <5 ng/mL (OR, 2.921; 95% CI, 1.365–6.253) were independent predictors for pCR. Obesity was not associated with disease-free survival or local recurrence-free survival.

Conclusion

Obesity was an independent predictive factor for pCR following nCRT in rectal cancer, but was not associated with recurrence. Further studies are needed to clarify the association between obesity and prognosis of rectal cancer after nCRT.

Copyright © 2019. Korean Association of Medical Journal Editors.