Björn Gebauer1,2, Frank Meyer1,2, Henry Ptok1,2, Ralf Steinert3, Ronny Otto1, Hans Lippert1, Ingo Gastinger1. 1. Institute of Quality Assurance in Operative Medicine, Otto-von-Guericke University at Magdeburg, Magdeburg, Germany. 2. Department of General, Abdominal, Vascular and Transplant Surgery, University Hospital, Magdeburg, Germany. 3. Department of General and Abdominal Surgery, St Joseph Hospital, Salzkotten, Germany.
Abstract
BACKGROUND: The aim of this study was to investigate the impact of obesity and underweight onto early postoperative and long-term oncological outcome after surgery for rectal cancer. METHODS: Data from 2008 until 2011 was gathered by a German prospective multicenter observational study. 62 items were reported by the physicians in charge, and a consecutive follow-up was performed if the patient had signed a consent form. Patients were subclassified into: underweight, normal weight, overweight, and obese - using the definitions of the World Health Organization. RESULTS: In total, 9,920 patients were included, of whom 2.1% were underweight and 19.4% obese. The mean age was 68 years (range 21-99 years). Postoperative morbidity (mean 38.0%) was significantly increased in underweight and obese patients (p < 0.001). In-hospital mortality was 3.1% on average with no significant differences among patient groups (p = 0.176). The 5-year overall survival ranged between 36.9 and 61.3% and was worse in underweight and prolonged in overweight and obese patients compared to those with normal weight (p < 0.001 each). While the 5-year disease-free survival was increased in overweight and obese patients (p < 0.05 each), the 5-year local recurrence rate showed no correlation (p > 0.05 each). Multivariate analysis revealed that advanced age, higher ASA scoring, postoperative morbidity, and advanced tumor growth worsened the long-term survival independently. CONCLUSIONS: Underweight patients had a worse early and long-term outcome after rectal cancer surgery. Overweight and obesity were associated with a significantly better long-term survival.
BACKGROUND: The aim of this study was to investigate the impact of obesity and underweight onto early postoperative and long-term oncological outcome after surgery for rectal cancer. METHODS: Data from 2008 until 2011 was gathered by a German prospective multicenter observational study. 62 items were reported by the physicians in charge, and a consecutive follow-up was performed if the patient had signed a consent form. Patients were subclassified into: underweight, normal weight, overweight, and obese - using the definitions of the World Health Organization. RESULTS: In total, 9,920 patients were included, of whom 2.1% were underweight and 19.4% obese. The mean age was 68 years (range 21-99 years). Postoperative morbidity (mean 38.0%) was significantly increased in underweight and obese patients (p < 0.001). In-hospital mortality was 3.1% on average with no significant differences among patient groups (p = 0.176). The 5-year overall survival ranged between 36.9 and 61.3% and was worse in underweight and prolonged in overweight and obese patients compared to those with normal weight (p < 0.001 each). While the 5-year disease-free survival was increased in overweight and obese patients (p < 0.05 each), the 5-year local recurrence rate showed no correlation (p > 0.05 each). Multivariate analysis revealed that advanced age, higher ASA scoring, postoperative morbidity, and advanced tumor growth worsened the long-term survival independently. CONCLUSIONS: Underweight patients had a worse early and long-term outcome after rectal cancer surgery. Overweight and obesity were associated with a significantly better long-term survival.
Entities:
Keywords:
Body mass index, BMI; Prospective multicenter observational study; Rectal cancer; Research on clinical care
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