Pathologic Outcomes and Survival in Patients with Rectal Cancer and Increased Body Mass Index.

IF 1.8 3区医学 Q3 GASTROENTEROLOGY & HEPATOLOGY

Digestive Surgery Pub Date : 2024-01-01 Epub Date: 2024-08-23 DOI:10.1159/000541085

Sameh Hany Emile, Giovanna Dasilva, Nir Horesh, Zoe Garoufalia, Rachel Gefen, Peige Zhou, Mariana Berho, Steven D Wexner

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引用次数: 0

Abstract

Introduction: We assessed the association between increased body mass index (BMI) and rectal cancer outcomes.

Methods: We included patients who underwent surgery for stage I-III rectal adenocarcinoma who were divided according to BMI at diagnosis: ideal BMI (18.5-24.9 kg/m2) and increased BMI (≥25 kg/m2). Groups were compared using univariate association analyses relative to baseline characteristics, pathologic outcomes, overall survival (OS), and disease-free survival (DFS). Main outcome measures involved circumferential resection margin (CRM), pathologic TNM stage, total mesorectal incision (TME) grade, OS, and DFS.

Results: 243 patients (64.6% male; median age 59 years) with a median BMI of 26.3 kg/m2 were included. 62.1% had BMI ≥25 kg/m2. Increased BMI patients had similar proportions of males (66.9% vs. 60.9%; p = 0.407) and comorbidities (ASA III: 47% vs. 37.4%; p = 0.24) to ideal BMI patients. There were no significant differences in cN1-2 stage (p = 0.279) or positive CRM (p = 0.062) rates. The groups had similar complete/near-complete TME, pathologic TN stage, and survival rates. Pathologic and survival outcomes were also similar with a BMI cutoff of 30.

Conclusions: There was a trend toward more nodal involvement in preoperative assessment and less CRM involvement in the final pathology of patients with increased BMI. Complete/near-complete TME and survival rates were comparable between the groups.

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体质指数增高的直肠癌患者的病理结果和生存率

简介：我们评估了体重指数（BMI）增加与直肠癌预后之间的关系：我们评估了体重指数（BMI）增加与直肠癌预后之间的关系：我们纳入了接受手术治疗的 I-III 期直肠腺癌患者，并根据诊断时的体重指数对其进行了划分：理想体重指数（18.5-24.9 kg/m2）和增加体重指数（≥25 kg/m2）。通过单变量关联分析比较了各组的基线特征、病理结果、总生存期（OS）和无病生存期（DFS）。主要结果指标包括周缘切除缘（CRM）、病理TNM分期、总直肠间膜切口（TME）分级、OS和DFS。结果：共纳入243例患者（64.6%为男性；中位年龄59岁），中位体重指数（BMI）为26.3 kg/m2。62.1%的患者体重指数≥25 kg/m2。与理想体重指数患者相比，体重指数增加患者的男性比例（66.9% vs 60.9%；P=0.407）和合并症比例（ASA III：47% vs 37.4%；P=0.24）相似。cN1-2 期（p=0.279）或 CRM 阳性率（p=0.062）无明显差异。两组患者的完全/接近完全TME、病理TN分期和生存率相似。以 BMI 30.为界限，病理和生存结果也相似：结论：在术前评估中，BMI 增加的患者有更多结节受累的趋势，而在最终病理结果中，CRM 受累较少。两组患者的完全/近完全TME和生存率相当。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Digestive Surgery 医学-外科

CiteScore

4.90

自引率

3.70%

发文量

审稿时长

3 months

期刊介绍： ''Digestive Surgery'' presents a comprehensive overview in the field of gastrointestinal surgery. Interdisciplinary in scope, the journal keeps the specialist aware of advances in all fields that contribute to improvements in the diagnosis and treatment of gastrointestinal disease. Particular emphasis is given to articles that evaluate not only recent clinical developments, especially clinical trials and technical innovations such as new endoscopic and laparoscopic procedures, but also relevant translational research. Each contribution is carefully aligned with the need of the digestive surgeon. Thus, the journal is an important component of the continuing medical education of surgeons who want their practice to benefit from a familiarity with new knowledge in all its dimensions.