Effects of body composition profiles on oncological outcomes and postoperative intraabdominal infection following colorectal cancer surgery

Surg Obes Relat Dis. 2021 Mar;17(3):575-584. doi: 10.1016/j.soard.2020.10.022. Epub 2020 Oct 26.

Abstract

Background: Anthropometric data as prognostic factors of colorectal cancer are promising but contradictory. The aim of this study was to assess the preoperative body composition profiles as predictive factors for postoperative, oncologic, and inflammation outcomes.

Objectives: We sought to assess the impact of body composition profiles on short- and long-term outcomes and on postoperative inflammatory response in a clinical setting for patients following curative intent surgery for colorectal cancer.

Setting: University hopsital METHODS: We analyzed 122 patients from a prospective cohort (IMACORS) with colorectal cancer undergoing curative-intent surgery from 2011 to 2014. Musculature, total, visceral, and subcutaneous adiposity were measured from a preoperative CT scan and outcomes were compared between profiles.

Results: Preoperative myopenia was an independent predictive factor of recurrence (HR = 3.3 95% CI = 1.6-6.9; P = .002) while subcutaneous adiposity was a protective factor (HR = .4 95% CI = .2-.9; P = .03). No anthropometric measurement was predictive of overall survival and postoperative intra abdominal infection was not determined by body composition profiles. Preoperative and D4 CRP levels were significantly higher in patients with subcutaneous adiposity.

Conclusions: Myopenia and subcutaneous adiposity seemed to have independent and opposite prognostic effects on recurrence. Muscle mass loss may represent a modifiable risk factor while the amount of subcutaneous adipose tissue reflects an energetic storage favorable to face this pathologic process.

Keywords: Adiposity; Body composition; CRP; Colorectal cancer; Myopenia; Survival.

MeSH terms

  • Body Composition
  • Body Mass Index
  • Colorectal Neoplasms* / surgery
  • Humans
  • Intra-Abdominal Fat
  • Intraabdominal Infections*
  • Neoplasm Recurrence, Local
  • Prognosis
  • Prospective Studies