Cookies on this website

We use cookies to ensure that we give you the best experience on our website. If you click 'Accept all cookies' we'll assume that you are happy to receive all cookies and you won't see this message again. If you click 'Reject all non-essential cookies' only necessary cookies providing core functionality such as security, network management, and accessibility will be enabled. Click 'Find out more' for information on how to change your cookie settings.

AIM: Despite their promise as prognostic factors in colorectal cancer, anthropometric data are frequently contradictory or difficult to interpret, with single body-composition parameters often investigated in isolation or heterogeneous clinical cohorts used in analyses. We sought to assess a spectrum of body-composition parameters in a highly selected cohort with locally advanced rectal cancer in a bid to determine those with strongest prognostic potential in this specific setting. MATERIALS/METHODS: Between 2014 and 2020, 78 individuals received neoadjuvant chemotherapy, or chemoradiotherapy, followed by radical surgery in the treatment of locally advanced rectal adenocarcinoma at Oxford University Hospitals Trust. Demographic, treatment-related, perioperative, and short-term outcomes data were assessed. Body-composition parameters included BMI, and those derived from pre-operative computed-tomography imaging: skeletal mass index (SMI), visceral fat area (VFA), subcutaneous fat area (SFA), perinephric fat area (PFA) visceral-to-subcutaneous fat ratio (V/S), sarcopenia, and sarcopenic obesity (SO). RESULTS: Pre-operative body-composition parameters exhibited particularly strong correlation with post-operative outcomes, with VFA (p = 0.002), V/S (p = 0.019), SO (p = 0.012), and PFA (p = 0.0016) all associated with an increased length of hospital stay. Univariate and multivariate analyses demonstrated V/S to be the sole independent body-composition risk factor to be associated with an increased risk of developing Clavien-Dindo complications ≥ 2 (p = 0.033) as well as an increased length of stay (p = 0.005). CONCLUSION: Among patients with locally advanced rectal cancer, high visceral-to-subcutaneous fat ratio is the body-composition parameter most strongly associated with poor early post-operative outcomes. This should be considered in patient selection and prehabilitation protocols. WHAT DOES THIS PAPER ADD TO THE LITERATURE? : Our study demonstrates that among body composition parameters, high visceral-to-subcutaneous fat ratio is strongly associated with increased risk of post-operative complications and increased length of stay in patients undergoing surgery for advanced rectal cancer.

Original publication

DOI

10.1007/s00384-022-04221-8

Type

Journal article

Journal

Int J Colorectal Dis

Publication Date

08/2022

Volume

37

Pages

1893 - 1900

Keywords

Advanced rectal cancer, Body composition parameters, Prehabilitation, Surgical outcomes, Visceral-to-subcutaneous fat ratio, Body Mass Index, Humans, Intra-Abdominal Fat, Neoadjuvant Therapy, Obesity, Rectal Neoplasms, Retrospective Studies, Sarcopenia, Subcutaneous Fat