Impact of body mass index as a continuous variable on short- and long-term outcomes in patients undergoing laparoscopic surgery for colon cancer

IF 2.9 4区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Annals of Gastroenterological Surgery Pub Date : 2025-01-23 DOI:10.1002/ags3.12916

Takayuki Aiba, Tomonori Akagi, Hidefumi Shiroshita, Kentaro Nakajima, Tetsuji Ohyama, Tatsuya Kinjo, Akiyoshi Kanazawa, Nobuaki Suzuki, Takuya Tokunaga, Manabu Yamamoto, Nobuki Ichikawa, Shungo Endo, Yutaka Kojima, Takatoshi Nakamura, Shuji Saito, Yoshinori Kagawa, Shinobu Ohnuma, Seiichiro Yamamoto, Takeshi Naitoh, Masafumi Inomata

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Abstract

Background

The impact of obesity on colon cancer remains unclear. Very few studies of colon cancer surgery have analyzed body mass index (BMI) as a continuous variable, with no such reports from Japan. This study examined the association between BMI as a continuous variable and short- and long-term outcomes of laparoscopic surgery for obese colon cancer patients.

Methods

Obese (BMI ≥25 kg/m²) patients who underwent laparoscopic radical surgery for Stage II/III colon cancer at 46 participating centers from 2009 to 2013 were included. Associations between short- and long-term outcomes and BMI as a continuous variable were analyzed by univariate and multivariate regression models.

Results

Among patients meeting the study criteria, 1036 were examined. BMI as a continuous variable correlated with log-transformed operative time (regression coefficient: 0.02, 95% confidence interval [CI]: 0.012–0.028, p < 0.05) and blood loss (odds ratio: 1.089, 95% CI: 1.032–1.149, p < 0.05). There was no association between BMI continuous variables and 3-year relapse-free survival (RFS) and overall survival. However, 3-year RFS was possibly better in patients with BMI ≥28.5 kg/m² versus those with BMI <28.5 kg/m² (hazard ratio: 0.682, 95% CI: 0.462–1.008, p = 0.055).

Conclusions

This study showed that BMI as a continuous variable correlated with operative time and blood loss. RFS was possibly better in the severely obese patients (BMI ≥28.5 kg/m²), suggesting that the prognosis for highly obese colon cancer patients appears to follow the obesity paradox.

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体重指数作为连续变量对结肠癌腹腔镜手术患者短期和长期预后的影响

肥胖对结肠癌的影响尚不清楚。很少有关于结肠癌手术的研究将身体质量指数（BMI）作为一个连续变量进行分析，日本也没有这样的报道。本研究考察了BMI作为一个连续变量与肥胖结肠癌患者腹腔镜手术的短期和长期结果之间的关系。方法选取2009 - 2013年在46个参与中心接受腹腔镜II/III期结肠癌根治术的肥胖（BMI≥25 kg/m2）患者。通过单变量和多变量回归模型分析短期和长期结果与BMI作为连续变量之间的关系。结果在符合研究标准的患者中，检查了1036例。BMI作为一个连续变量与对数变换后的手术时间（回归系数：0.02,95%可信区间[CI]: 0.012-0.028, p < 0.05）和出血量（优势比：1.089,95% CI: 1.032-1.149, p < 0.05）相关。BMI连续变量与3年无复发生存期（RFS）和总生存期之间没有关联。然而，BMI≥28.5 kg/m2的患者3年RFS可能优于BMI≤28.5 kg/m2的患者（风险比：0.682,95% CI: 0.462-1.008, p = 0.055）。结论BMI是一个连续变量，与手术时间和出血量相关。重度肥胖患者（BMI≥28.5 kg/m2）的RFS可能更好，提示重度肥胖结肠癌患者的预后似乎遵循肥胖悖论。

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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