title: Quantitative Assessment of Visceral Obesity and Postoperative Colon Cancer Outcomes.
abstract: Quantitative computed tomography (CT) assessment of visceral adiposity may be superior to body mass index (BMI) as a predictor of surgical morbidity. We sought to examine the association of CT measures of obesity and BMI with short-term postoperative outcomes in colon cancer patients.
  
  
  
  In this retrospective study, 110 patients treated with colectomy for stage I-III colon cancer were classified as obese or non-obese by preoperative CT-based measures of adiposity or BMI [obese: BMI ≥ 30 kg/m2, visceral fat area (VFA) to subcutaneous fat area ratio (V/S) ≥0.4, and VFA > 100 cm2]. Postoperative morbidity and mortality rates were compared.
  
  
  
  Obese patients, by V/S and VFA but not BMI, were more likely to be male and have preexisting hypertension and diabetes. The overall complication rate was 25.5%, and there were no mortalities. Obese patients by VFA (with a trend for V/S but not BMI) were more likely to develop postoperative complications as compared to patients classified as non-obese: VFA (30.5 vs.10.7%, p = 0.03), V/S (29.2 vs. 9.5%, p = 0.05), and BMI (32.4 vs. 21.9%, p = 0.23).
  
  
  
  Elevated visceral obesity quantified by CT is associated with the presence of key metabolic comorbidities and increased postoperative morbidity and may be superior to BMI for risk stratification.
authors.affiliation: Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, FL, USA.|Department of Global Health, College of Public Health, University of South Florida, Tampa, FL, USA.
authors.forename: Oluwatobi O
authors.initials: OO
authors.lastname: Ozoya
authors.affiliation: Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, FL, USA.|Health Research Informatics, Moffitt Cancer Center, Tampa, FL, USA.
authors.forename: Erin M
authors.initials: EM
authors.lastname: Siegel
authors.affiliation: Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, FL, USA.|Morsani College of Medicine, University of South Florida, Tampa, FL, USA.
authors.forename: Thejal
authors.initials: T
authors.lastname: Srikumar
authors.affiliation: Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, FL, USA.
authors.forename: Amanda M
authors.initials: AM
authors.lastname: Bloomer
authors.affiliation: Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, FL, USA.
authors.forename: Amanda
authors.initials: A
authors.lastname: DeRenzis
authors.affiliation: Department of Surgery, University of Tennessee Health Science Center, 910 Madison Avenue, Room 203, Memphis, TN, 38163, USA. dshibata@uthsc.edu.
authors.forename: David
authors.identifier: 0000-0002-5670-423X
authors.initials: D
authors.lastname: Shibata
mesh_terms: D000368:Aged; D015992:Body Mass Index; D003082:Colectomy / Q000009:adverse effects / Q000706:statistics & numerical data*; D003110:Colonic Neoplasms / Q000150:complications / Q000601:surgery*; D015897:Comorbidity; D005260:Female; D006801:Humans; D050152:Intra-Abdominal Fat / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D056128:Obesity, Abdominal / Q000150:complications / Q000000981:diagnostic imaging*; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D050151:Subcutaneous Fat / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
keywords: Colon cancer; Computed tomography; Surgical complication; Visceral obesity