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Impact of Visceral Fat on Survival and Metastasis of Stage III Colorectal Cancer

 Jung Won Park  ;  Soo Yeon Chang  ;  Joon Seok Lim  ;  Soo Jung Park  ;  Jae Jun Park  ;  Jae Hee Cheon  ;  Won Ho Kim  ;  Tae Il Kim 
 GUT AND LIVER, Vol.16(1) : 53-61, 2022-01 
Journal Title
Issue Date
Body Mass Index ; Colorectal Neoplasms* / pathology ; Humans ; Intra-Abdominal Fat* / diagnostic imaging ; Intra-Abdominal Fat* / pathology ; Obesity, Abdominal / complications ; Retrospective Studies ; Subcutaneous Fat / diagnostic imaging ; Subcutaneous Fat / pathology
Colorectal neoplasms ; Fat ; Obesity ; Outcome ; Visceral
Background/aims: Previous studies have investigated the relationship between visceral obesity and the risk of colorectal tumors. Visceral obesity may affect the outcome of colorectal cancer (CRC), including survival and metastasis. We investigated the associations between visceral adipose tissue and oncologic outcomes in stage III CRC.

Methods: Four hundred seventy-two patients with stage III CRC were identified. Subcutaneous and visceral adipose tissue areas were measured volumetrically via computed tomography for each patient at different levels of the lumbar spine. After adjusting for age, sex, and other clinical factors, the effects of visceral adipose tissue area on mortality and recurrence were assessed using Cox proportional hazard regression.

Results: In univariate and multivariate analyses, a higher visceral adipose tissue to total adipose tissue (VT) ratio (hazard ratio [HR], 1.041; 95% CI, 1.008 to 1.075; p=0.015) and higher visceral adipose tissue to subcutaneous adipose tissue (VS) ratio (HR, 1.016; 95% CI, 1.005 to 1.028; p=0.006) were both associated with poor CRC-specific survival. Interestingly, in the evaluation of each site of recurrence, a higher VT ratio (HR, 1.069; 95% CI, 1.010 to 1.131; p=0.020) and higher VS ratio (HR, 1.024; 95% CI, 1.003 to 1.045; p=0.023) were both related to a higher risk of peritoneal seeding and tumor recurrence. The VT ratio at the L3-L4 level was significantly associated with a higher risk of peritoneal seeding and tumor recurrence (HR, 4.969; 95% CI, 1.303 to 18.949; p=0.019), while other levels showed no such relationship.

Conclusions: Visceral obesity is closely related to increased risks of CRC-specific mortality and peritoneal seeding metastasis in stage III CRC patients.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Won Ho(김원호) ORCID logo https://orcid.org/0000-0002-5682-9972
Kim, Tae Il(김태일) ORCID logo https://orcid.org/0000-0003-4807-890X
Park, Soo Jung(박수정)
Park, Jae Jun(박재준)
Park, Jung Won(박중원) ORCID logo https://orcid.org/0000-0003-0249-8749
Lim, Joon Seok(임준석) ORCID logo https://orcid.org/0000-0002-0334-5042
Chang, Soo Yun(장수연)
Cheon, Jae Hee(천재희) ORCID logo https://orcid.org/0000-0002-2282-8904
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