title: Prognostic Impact of Changes in Adipose Tissue Areas after Colectomy in Colorectal Cancer Patients.
abstract: There have been few studies assessing the changes in the body components of patients after colectomy in colorectal cancer (CRC). The purpose of this study was to verify the trends in the adipose tissue areas of CRC patients before and after surgery and to determine their clinical relevance. Computed tomography (CT)-assessed subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT) areas were recorded before and after curative resection in stage I to III CRC patients. Changes in the adipose tissue were assessed by calculating the difference in the adipose tissue area between preoperative CT and the most recent postoperative CT, which is disease-free state. Regarding obesity before surgery, there were no prognostic effect of body mass index (BMI), VAT and SAT, and 47.3% of patients had increases in VAT after colectomy. By multivariate analysis, adjusting sex, age, stage, differentiation, VAT change was the only obesity related factor to predict the prognosis, that patients who had increase in VAT after colectomy had better overall survival (HR, 0.557; 95% CI, 0.317-0.880) and disease-free survival (HR, 0.602; 95% CI, 0.391-0.927). BMI and SAT change had no significant association. In subgroup analysis of stage III CRC patients, VAT change had significance for prognosis only in patients who had adjuvant chemotherapy but not in those who did not receive postoperative chemotherapy. Increase in visceral adipose tissue after surgery is a favorable predictor of prognosis for CRC patients.
authors.affiliation: Department of Surgery, Seoul National University College of Medicine, Seoul, Korea.|Department of Surgery, Seoul National University Hospital Healthcare System Gangnam Center, Seoul, Korea.
authors.forename: Eun Kyung
authors.identifier: http://orcid.org/0000-0002-7222-1772
authors.initials: EK
authors.lastname: Choe
authors.affiliation: Department of Surgery, Seoul National University College of Medicine, Seoul, Korea. kjparkmd@plaza.snu.ac.kr.
authors.forename: Kyu Joo
authors.identifier: http://orcid.org/0000-0002-9134-7426
authors.initials: KJ
authors.lastname: Park
authors.affiliation: Department of Surgery, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Seung Bum
authors.identifier: http://orcid.org/0000-0001-6407-0444
authors.initials: SB
authors.lastname: Ryoo
authors.affiliation: Office of Medical Education, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Sang Hui
authors.identifier: http://orcid.org/0000-0003-1102-8714
authors.initials: SH
authors.lastname: Moon
authors.affiliation: Department of Surgery, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Heung Kwon
authors.identifier: http://orcid.org/0000-0002-8066-2367
authors.initials: HK
authors.lastname: Oh
authors.affiliation: Department of Surgery, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Eon Chul
authors.identifier: http://orcid.org/0000-0001-5987-3752
authors.initials: EC
authors.lastname: Han
mesh_terms: D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use; D015992:Body Mass Index; D003082:Colectomy; D015179:Colorectal Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D050152:Intra-Abdominal Fat / Q000000981:diagnostic imaging*; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D009765:Obesity / Q000209:etiology; D011379:Prognosis; D016016:Proportional Hazards Models; D012307:Risk Factors; D050151:Subcutaneous Fat / Q000000981:diagnostic imaging*; D014057:Tomography, X-Ray Computed
chemical_list: D000970:Antineoplastic Agents
keywords: Adipose Tissue; Colorectal Neoplasms; Obesity; Prognosis